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Reokivbd ih Exchakob 

Lafayette CoUoge 

ijiM-;jrj i mmi j:^.r''xjl i. i.i. Li.i . i . i[iiiilli 





Medical Society 





w> J » 

> O 


.• . •• " J 

Jennings & Hardham, Steam Printers and Bookbinders, 

153 and 155 Market Street. 


OFFICERS, d876, 

JNO. V. SCHENCK, Camden. 


1ST. HENRY R. BALDWIN, . . . New Brunswick. 

2D. JNO. S. COOK, .... Hackettstown. 
3D. ALEX. W. ROGERS, Paterson. 

WM. ELMER, Jr., . . . . . . Trenton. 

WM. PIERSON, Jr., Orange. 

W. W. L. PHILLIPS, Trenton. 


' * " ' • 
STEPHEN WICKES, Permaiieit 'Chairman, Orange. 

JOS. L. BODINE, Trenton. 

SAM'L LILLY, Lambertville. 


♦Lewis Dunham 1816 

♦Peter I. Strtker 1817 

♦John Van Clevb 1818 

♦Lkwis Condict 1819 

♦James Lbb 1820 

♦William G. Reynolds 1821 

All persons who shall have been, or may hereafter be President of the Society, shall 
rank as Fellows, and be entitled to all the privileges of delegited members. 

Act qf Incorporation^ Sec. 1. 

Those marked thus [*] are deceased. 

♦Robert McEban 1776 ♦Charles Smith 1811 

♦William Burnett 1767 ♦Matt. H. Williamson 1812 

♦John Cochran 1768 ♦Samuel Forman 1814 

♦Nathaniel Scudder 1770 ♦John Van Clevb 1815 

♦Isaac Smith 1771 

♦James Newell 1772 

♦Absalom Bainbridge 1773 

♦Thomas Wiggins 1774 

♦Hezekiah Stites 1775 

^P ^p ^F ^p T ^n 

♦John Beatty 1782 ♦Augustus R. Taylor 1822 

♦Thomas Barber 1783 ♦William B. Ewinq .... 1823 

♦Lawrence Van Derveer. . . 1784 ♦Peter I. Stryker 1824 

♦Moses Bloomfield 1785 ♦Gilbert S. Woodhull . . . 1825 

♦William Burnett 1786 ♦Wm. D. McKissack 1826 

♦Jonathan Elmer 1787 ♦Isaac Pierson 1827 

♦James Stratton 1788 ♦Jephtha B. Munn 1828 

♦MosEsScoTT 1789 ♦John W. Craig 1829 

♦John Griffith 1790 ♦Augustus R. Taylor 1 830 

♦Lewis Dunham 1791 

♦Isaac Harris 1792 

♦James Newell 1795 

♦Jonathan F. Morris. , 1807 

♦Peter I. Stryker 1808 

♦Lewis Morgan 1809 

♦Lewis Condict 1810 

♦Thomas Yarrow 1831 

♦Fitz Randolph Smith 1832 

♦William Forman 1833 

♦Samuel Hayes 1834 

♦Abm. p. Hagerman 1835 

♦Henry Van Derveer 1836 

♦Lyndon A. Smith 1837 


♦Bbnj. H. Stratton 1838 

♦Jabez G. Goblb 1839 

*Thoma8 p. Stewart 1840 

♦Ferdinand S. Schbnck 1841 

Zachariah Rbbd 1842 

♦Abraham Skillman 1843 

George R. Chetwood 1844 

♦Robert S. Smith 1845 

♦Charles Hannah 1846 

♦Jacob T. B. Skillman 1847 

Samuel H. Pennington. . . . 1848 

Joseph Fithian 1849 

♦Elias J. Marsh 1850 

John H. Phillips 1851 

♦Othn'l H. Taylor 1852 

Samuel Lilly 1853 

♦A. B. Dayton 1854 

J. B. Coleman 1855 

♦Richard M. Cooper 1856 

Thomas Ryerson 1857 

♦Isaac P. Coleman 1858 

John R. Sickler 1859 

Wm. Elmer 1860 

Jno. Blane 1861 

Jno. Woolverton 1862 

Theo. R. Varick 1863 

Ezra M. Hunt 1864 

Abram Coles 1865 

Ben J. R. Bateman 1866 

Jno. C. Johnson 1867 

Thos. J. Corson 1868 

Wm. PiERSON 1869 

Thos. F. Cullen 1870 

Chas. Hasbrouck 1871 

Franklin Gauntt 1872 

T. J. Thomason 1873 

G. H. Larison 1874 

Wm. O'Gorman 1876 



♦David Hosack, New York 1827 

*J. W.Francis 1827 

♦John Condict, Orange 1830 

♦Noah Parsons, Rhode Island 1839 

♦Reuben D. Murphy, Cincinnati 1839 

Alban G. Smith, New York 1839 

WiLLARD Parker, New York 1842 

♦Valentine Mott, New York 1843 

♦Jonathan Knight, New Haven 1848 

♦Nath'l Chapman, Philadelphia ! 1848 

♦Alex. H. Stephens, New York 1848 

♦Lewis C. Beck, New York 1850 

♦John C. Torrey, New York 1850 

George B. Wood, Philadelphia 1 853 

H. A. Buttolph, Morris Plains, N. J 1854 

AsHBEL Woodward, Franklin, Conn 1861 

♦Thos. W. Blatchpord, Troy, N. Y 1861 

Jeremiah S. English, Manalapan, N. J 1867 

Stephen Wickes, Orange, N. J 1868 

S. O. Vanderpool, Albany, N. Y. 1872 

Jos. Parrish, Media, Pton 1872 

Ferris Jacobs, Delhi, N. Y 1872 

C. A. Lindslby, New Haven, Conn 1872 

Wm. Pepper, Philadelphia 1874 

J. Weir Mitchell, Philadelphia 1876 





(District Society organized February a8, 1854. ) 

M. B. Ayres, 


C. Hasbrouck, 


A. S. Bardett, 


H. A. Hopper, 


D. C. Carr, 


H. C. Neer, 

Park Ridge. 

A. Clendinen, 

Fort Lee, 

J. M. Simpson, 


D. A. Currie, 


D. St. John, 


F. A. Davis, 


G. C. Terhune, 


J. T. DeMund, 


A. P. Williams, 


J. J. Haring, 


S. J. Zabriskie, 


No. Members, 


Chas. Hasbrouck, Secretary. 


(District Society organized May 19, 1829.) 

J. H. Pagh, 


E. P. Townsend, 


Franklin Gauntt, 


A. W.Taylor, 


L. Van Rensselaer, 


Alex. Elwell, 


Joseph Parrish, 


S. C. Thornton, 


Chas. A. Baker, 


N. N. Stokes, 


Henry H. Longstreet, 


Lewis Sharp, 


Irene D. Young, 


J. Reeve, 


L. P. Jemison, 


Theophilus T. Price, 


R. H. Page, 


Stanley G. Clark, 


Daniel Van Mater, 


E. Hollingshead, 


A . E. Budd, 

Mt. HoUy. 

George Goodell, 


R. E. Brown 


No. Members, 28. 

E. P. TowNBEND, Secretary. 



John V. Schenck, 
Thomas F. Cullen, 
H. Genet Taylor, 
Alexander Marcy, 
James M. Ridge, 
Alexander M. Mecray, 
J. Orlando White, 
Randall W. Morgan, 
Richardson B. Okie, 
Isaac B. Mulford, Jr., 
D. Parriah Pancoast, 
John R. Haney, 
W. H. Ireland, 
Thomas Westcott, 
Maximillian West, 
L. L. B. Godfrey, 




(Organized August 14, 1846.) 

Camien, Thomas G. Rowand, 
James A. Armstrong, 
E. J. Snitcher, 
W. P. Melcher, 
John W. Spowden, 
N. B. Jennings, 
I. W. Hewlings, Jr., 

C. H. Shivers, 
J. Gilbert Young, 
John R. Stevenson, 
H. L. Branin, Blaekvooodtown. 
J. W. McCullough, " 
H. A. M. Smith, Gloucester City. 
George W. Broughman, 
Edwin Tomlinson, 

D. W. Blake, 









Joseph F. Garrison, Camden. A. D. Woodruff, PrincessAnne^ Md. 

R. C. Dean, U. 8.N., Washington. Peter V. Schenck, St, Louis^ Mo. 

No. Members, 32. H. Genet Tayloii, Secretary. 


(Organized December 8, z8z8.) 

B. R. Bateman, 


Jos. Sheppard, 


E. E. Bateman, 


H. W. Elmer, 


Eph. Bateman, 


W. L. Newell, 


R. M. Bateman, 


J. S. Whitaker, 


George Tomlinson, 


C. H. Dare, 


J. Barron Potter, 


Geo. M. PauUen, 


T. J. Smith, 


S. G. Cattell, 


R. W. Elmer, 


T. E. Stathem, 


W. Elmer, Sr., 


D. B. IngersoU, 

Map^s Landing. 


Enoch Fithian, Oreenwich, 

No. Members, 18. H. W. Elmer, Secretary. 



B8SEX ( 


(Society organized June 4, x8z6.) 

— Bailey, 


Archibald Mercer, 


Aaron K. Baldwin, 


Andrew M. Mills, 


M. Baldwin, 


Edward P. Nichols, 


Hermann C. Bleyle, 


Isaac A. Nichols, 


Carl Bnttner, 


Wm. O^Gorman, 


T. N. Bradfield, 


Sam'l H. Pennington, 


Wm. J. Chandler, 

8, Orange, 

Stephen Personett, 


Abram Colea, 




J. C. Corson, 


Wm. Pierson, 


J. A. Corwin, 


Wm. Pierson, jr.. 


L.1L Crane, 

J. W. Pinkham, 


J. A. Cross, 


Wm. Rankin, 


Daniel M. DiU, 


Phillippe Ricord, 


Alexander N. Dongherty, ** 

Dayid 8. Smith, 


A. Mead Edwards, 


D. Winans Smith, 


Christopher Eyrich, 


Edward D. G. Smith, 


Geo. C. Freeborn, 


Lott Southard, 


W. B. GroTer, 


Charles W. Stickney, 


Ella Haines, 


E. B. Thompson, 


TreTonion Haight, 


M. H. C. Vail, 


H. Campbell Hendry, 


G. A. Van Wagenen, 


Peter V. Hewett, 


Arthur Ward, 


Edgar Holden, 


Leslie D. Ward, 


W. H. Holmes, 


E. T. Whittingham, 


Joseph B. Jackson, 


Stephen Wickes, 


Charles J. Eipp, 


Frank Wilmarth, 

E, Orange. 

Henry A. Eomemann, 


Charles Young, 


Jno. J. H. Lore, 


Charles M. Zeh, 


No. Members, 56. 

Chas. Youkg, 


aitOuaRSTEs coxjntt. 

(Society organized December, r8x8.) 

L. A. D. Allen, 


A. Trenchard, WULyxmstown, 

Wm. H. Turner, 


H. C. Buckingham, 


C. Grant Garrison, 


Jno. H. Ashcroft, MvUica MR, 

H. C. Clark, 


Jno. D. Heritage, 


8. T. Miller, 


Paul 8. Heritage, 


Samnel F. Fisler, 


No. Members, 11. 

Wm. H. TuBirsB, 






(Sooety organized October z, 1851.) 

L. W. Elder, 


B. A. Andrew, 

Jersey City. 

J. H. Vondy, 

Jersey City, 

F. C. Selnow, 


D. L. Reeve, 


J. A. Blake, 

West Hdboken, 

B. R. Form an. 


F. C. Ran, 


T. P. Morris, 


H. M. Eddy, 

Jersey City. 

E. P. Buffett, 


J. D. Van Saun, 


J. Kudlick, 


J. Lochner, 


J. W. Hunt, 

Jersey City, 

C. H. Yerrington, 


F. E. Noble, 


C. C. Young, 


J. Craig, 


R. W. Fry, 


J. B. Burdett, 


D. Murray, 


D. S. Hardenberg, 


M. Lampson, 


C. H. Case, 


J. R. Waldemeyer, 


C. 0. Veirs, 


L. J. Gordon, 


T. Geisler, 


H. Braunstein, 


J. J. Prendergast, 

Jersey City. 

A. Freeman, 

Jersey City. 

E. J. Lowenthal, 


S. V. W. Stout, 


A. A. Lutkins, 

Jersey City, 

W. C. Lutkins, 


B. D. Carpenter, 


Walter Bay, 


H. Mitchell, 


J. Q. Bird, 


No. Members, 


Wm. R. Fishkr, Secretary 

Matthias Abel, 
A. W. Armitage, 
John Blane, 
N. B. Boileau, 
Geo. W. Bartow, 
W. S. C reveling, 
Isaac S. Cramer, 
M. D. Knight, 
Wm. Knight, 
Sam'l Lilly, 
Geo. H. Larison, 

No. Members, 


(Society organized June za, z82z.) 

Quakertawn. C. W. Larison, 



Three Bridges. 



Little York, 




R. G. Ludlow, 
A. S. Pittinger, 
Geo. T. Ribble, 
Jno. F. Schenck, 
Wm. H. Schenck, 
Geo. R. Sullivan, 
Theo. H. Studdiford, 
Albert Shannon, 
O. H. Sproul, 



Clover Bill, 





O. H. Sproul, Secretary. 




(Society organized July 24, 1848.) 

James B. Coleman, 


Wm. Green, 


John Woolverton, 


Ed. H. Reed, 


W. W. L, Phillips, 


Chas. F. Deshler, 


Thomas J. Corson, 


1. 1. Ribble, 


Chas. Skelton, 


Wm. Elmer, 


Chas. Hodge, 


Herman Schaffer, 


0. H. Bartine, 


Lyman Levitt, 


R. R. Rogers, 


T. H. Makenzie, 


Charles Shepherd, 


J. W. Ward, 


David Warman 



Wm. S, Lalor, 


Jos. L. Bodine, 


A. W. Armitage, 


J. B. James, 


Charles H. Danham, 


I. H. Wykoflf, 


Charles P. Britton, 


H. W. Coleman, 


Elmer Barrows, Hamilton Square. 

No. Members, 28. 

H. Waldburg Colbman, Secretary. 

H. R. Baldwin, 
S. V. D. Clark, 
D. C. English, 
G. J. Janeway, 
W. E. Mattison, 

C. Morrogh, 
P. H. Shannon, 

D. Stephens, 
R. Van Dyke, 
C. H. Voorhees, 

No. Members, 19. 


(Society organized June 13, x8i6.) 

New Brunswick. N. Williamson, 

John Helm, 










C. H. Andrews, 
E. M. Hunt, 
P. B. Norton, 
J. C. Holmes, 
A. Treganowan, 
C. M. Slack, 

New Brunswick, 






South Awiboy, 


W: V. Wilson, Mbnmoitth Junction, 


(Society organized July 24, x8i6.) 

J. E. Arrowsmith, Keyport. James Holmes, 

Asher T. Applegate, Englishtown. Samuel Johnson, 

L A. Beegle, Blue Ball. Robert Laird, 

Robert R. Conover, Bed Bank. Charles A. Laird, 


Long Branch, 





Henry G. Cooke, Holmdd. 

John Cooke, EnglMtaum, 

James S. Conover, Freehold, 

Charles A. Conoyer, Marlborough, 
S. M. Disbrow, SquanJcum, 

D. McLean Forman, Freehold, 
Jos. B. Goodenough, Long Branch, 
A. A. Howell, AHentown. 

A. A. Higgins, SqiMn Wlage, 
S. H. Hunt, Eatontoutn, 

I. 8. Long. 
Wm. A. Newell, 
P. B. Pamyea, 
T. J. Thorn ason, 
John Vought, 
George T. Welch, 
Wilmer Hodgson, 
W. R. Kenmouth, 
James H. Patterson, 
James E. Cooper, 










Colt's Neck. 

J. S. English, 
Edward Taylor, 

No. Members, 28. 


Manalapan. A. V. Conover, Freehold. 


Jno. Vought, Secretary. 

C. Anderson, 

D. S. Ayres, 
P. C. Barker, 
L W. Condict, 
A. E. Carpenter, 

E. P. Cooper, 

T. R. Crittenden, 
J. O. Cammins, 
T. B. Flagler, 
Jos. S. Farrow, 
Levi Farrow, 
P. A. Harris, 
H. Hulshizer, 


(Society organized, June x, x8x6.) 

Madison, J. C. Lindsley, 
Hockaway, Chas. H. Ladlum, 
Morristown, A. A. McWithey, 
Dover, F. W. Miller, 
Boonton. F. W. Owen, 

Stephen Pierson, 
J. Riches, 
C. D. V. Romondt, 
J. G. Ryerson, 
F. F. Sanders, 
L H. Stiger, 
Jno. S. Stiger, 





Middle VaUey, 


Port Oram, 













I. C. Schureman, 
T>. C. Chase, 
P. K. Hilliard, 
E. Marston, 

No. Members, 7. 

C. O. Gordon, 
S. B. Irwin, 
R. L. Disbrow. 



C. R. Nelden, 
E. R. Gaines, 

No. Members, 25. 




Stanhope, N. Condict, 
Baantan. R. W. Stevenson, 

Stephen Pibrson, Secretary 


(Society organized July 14. 1844.) 

Oswald Warner, 

S. R. Merrill, 

Jas. C. Amiranx, 

J. R. Leal, 

Sarah F. Mackintosh, 

H. C. Van Gieson, 

G. H. Balleray, 

Patrick Cahill, 

Jacob Henggler, 

Wm. Blundell, 

T. J. Kane, 

Wm. Kent, 

L S. Bibby, 

C. Terriberry, 

C. Van Riper, 

J. C. Herrick, 

F. W. Rice, 

No. Members, 34. 








Ridley Kent, 
A. W. Rogers, 
R. J. Whiteley, 
Michael Moss, 
C. 8. Van Riper, 
E. J. Marsh, 
John Qain, 
O. V. Garnett, 
G. W. Terriberry, 
Wm. Busse, 
Jas. H. Macintosh, 
Chs. W. F. Myers, 
E. F. Brush, 
Spencer Van Dalsen, 
G. Terhune, 
R. A. Terhune, 
Jas. H. Casey, 






Jas. C. Amiraux, Secretary. 

T. H. Andress, Pres.^ 
J. L. Allen, 
Carlos Allen, 
J. B. Boss, 
F. M. Cannon, 
J. P. Couse, 
Martin Cole, Jr., 
C. K. Davidson, 


(Society organized August 23. 1829.) 

Sparta. John Moore, 

Lafayette. John Miller, 

Vernon. L. D. Miller, 

Sparta. Ephraim Morrison, 

DecJcertown. J. F. McCloughan, 

Hamburg. C. R. Nelden, 

HainsfoiMe. J. B. Pellet, 








Stanhope. Thomas Roe, Walpa>ck Centre. 



Joseph Hedges, Branchoille. Thomas Ryerson, 

Jonathan Havens, Sec'y, Newton, Franklin Smith, 

P. N. Jacobus, F. P., Beemeroille, D. M. Say re, 

W. H. Linn, Hamburg, H. McDonald Struble, 

C. V. Moore, StiUtoater, Eugene Schumo, 




No. of Members, 26. 

Jonathan Haybns, Secretary. 


(Society organized June 7, 1869.) 

C. H. Stillman, Pre8% 


T. L. Hough, 


Robert Westcott, V. P., 

, Elizabeth, 

E. B. Silvers, 


T. N. McLean, Secretary, " 

J. K. McConnell, 


J. A. Coles, Treas., Scotch Plains, 

J. S. Crane, 


H. H. James, Beporter, 


A. M. Cory, New Promdenee. 

L. W. Oakley, 


J, B. Probasco, 


D. W. C. Hough, 


T. H. Tomlinson, 


J. S. Green, 


H. C. Pierson, 


F. A. Kinch, 


Wm. K. Gray, 


J. 0. Pinneo, 


Sherman Cooper, 


Alonzo Pettit, 


F. B. Gillette, 


Thomas Terrill, 


H. D. Burlingham, 


Ph. H. Grier, 


E. V. Stryker, 


William Gale, 


Chas. A. Kinch, 


John S. Brosnan, 


Victor Mravlag, 


S. E. Arms, 


David Schleimer, 


J. H. Grier, 


William C. Boone, 


W. U. Selover, 


Lewis Drake, 


Louis Braun, 


C. F. Stillman, 


No. of Members, 38. 

T. N. McLean, Secretary. 




(Society organized February 15, 1836.) 

P. p. Brakeley, 


J. M. Paul, Jr., 


a S. Clark, 


H. S. Harris, 


P. P. Hulshizer, 


Wm. H. McGee, 


John C. JohnsoD, 


L. M. Osmun, 


L. C. Osmun, 


J. P. Shepperd, 


John S. Cook, 


John H. Griffith; 


Theodore Crane, 


Henry H. Rinehart, 


E. T. Blackwell, 


T. T. Mutchler, 


VVni. M. Hartpence, 


Wm. J. Roe, 



James C. Pitch, Hope. 

No. of Members, 18. P. P. Bbaksly, Secretary. 




. 16 


Burlington, . 



Morris, . 



. 32 


Cumberland, . 









• • 


Union, . 



. 40 



• • 




. 28 


Middlesex, . 

• • 








The Society assembled in the drawing-rooms of Con- 
gress Hall, in Cape May City, on Tuesday evening, 
May 23d, 1876, at 7.30 o'clock. 

Dr. Wm. O' Gorman, President, occupied the chair, 
supported by Vice-Presidents Schenck, Baldwin and 
Cook. All the officers, excepting Drs. Ryerson and 
Thornton of the Standing Committee, were present. 

The session was opened with prayer by the Rev. Mr. 
Shields, of Cape May. 

The Committee on Organization, by the Secretary 
reported the following as duly accredited delegates 
(Dr. L. W. Oakley acting on the Committee by appoint- 
ment of the President) : 

Bergen — D. A. Currie, A. Clendenin, H. A. Hopper, M. 8. Ayres.* 
Members, 16. 

Burlington^ Theo. T. Price, Joseph Parish,* Alex. Elwell, Franklin 
Qaunt, R. E. Brown. Members, 23. 

Gamden-^ZoYLii W. Snowden, Alex. Marcy, H. Qenet Taylor, Alex. 
M. Marcy, N. B. Jennings. Members, 82. 

Carriberla'nd—Z, S. Whitaker, T. J. Smith, Geo. Tomlinson, H. W. 
Elmer. Members, 19. 


Essex—A, N. Dougherty, W. RankiD, A. Mercer, J. A. Cross, J. J. 
H. Love, J. D. Ward, A. Ward, E. P. Nichols. Members, 56. 

Gloucester— S. F. Fisler, P. 8. Heritage, W. H. Turner. Members, 

Hudson— ¥. F. Morris, S. R. Forman, W. R. Fisher, J. B. Burdett, 
H. Mitchell, J. R. Waldmeyer. Members, 41. 

Eunterdon—Jsfisuc S. Cramer, O. H. Sproul, W. S. Creveling, Geo. W. 
Barton. Members, 20. 

Mercer— J), Warman, J. L B. Ribble, J. W. Ward, R. R. Rodgere, 
W. Green. Members, 28. 

Middlesex— G. J. Janeway, C. H. Voorhees, N. Williams, D. E. Eng- 
ish. Members, 18. 

Monmovth — J. E. Arrowsmith, Robt. R. Conover, Geo. T. Welch,* D. 
McLean Forman. Members, 28. 

Morris— 1>, L. Ay res, F. F. Sanders, J. G. Ryerson, E. P. Cooper, 
Levi Farron. Members, 25. 

Ocean — C. O. Gordon, P. K. Hilliard, S. B. Erwin. Members, 7. 

Passaic — G. H. Ballery, A. W. Rogers, James H. Mackintosh, J. R. 
Leal, Charles W. F. Myers, Jas. C. Amiraux. Members, 34. 

Sussex— T. H. Andress, J. B. Pellet, F. M. Cameron, Joseph Hedges. 
Members, 26. 

Union, — L. W. Oakley, J. A. Coles, T. H. Tomlinson, Jas. S. Green, 
W. U. Selover, B. B. Silvers. Members, 38. 

Warren— V. F. Brakely, L. M. Osmun, J. F. Sheppard, Wm. H. 
McGee. Nembers, 18 

Beporters—SssnR^ M. Ridge, Camden; F. Wilmarth,* Essex; C. 
Grant Garrison, Gloucester ; Leonard J. Gordon,* Hudson ; C. W. 
Larison, Hunterdon ; H.W.Coleman,* Mercer; D. C. English, Mid- 
dlesex ; P. C. Harris,* Morris ; Sarah F. Mackintosh,* Passaic ; H. H. 
James, Union ; 8. C. Thornton, Burlington. 

The Secretary also reported the following persons, 
delegates from Corresponding Societies, as being pre- 
sent : 

Drs. Goodell and Ash, of Pennsylvania ; Dr. Newman, of New York ; 
Dr. Wiggin, of Rhode Island ; Dr. Cutler, of Massachusetts ; and 
Dr. Bibber,t of Maine. 

Fellows Present—^, H. Pennington, Joseph Fithian, Samuel Lilly. 

* Absent. t Reported Bnbseqnently. 


Joseph R. Sickler, Wm. Elmer, Sr., John Blane, John Woolverton 
Ezra M. Hunt, Benj. R. Bateman, Thomas J. Corson, William Piersori; 
Sr., Thomas F. Oullen, Charles Hasbrouck, Franklin Gaontt, Thomas 
J. Thomason, George H. Larison. 

Honorary Members Present — J. S. English, S. Wickes and William 

The Minutes of the last Annual Meeting were read 
and approved. 

On motion of Dr. S. Lilly, the following resolution 
was adopted : 

Hesolved, That the delegates from corresponding Societies, Prof. D. 
Hays Agnew, Prof. W. Pepper, Drs. Levis, Atkinson, J. Solis Cohen, 
Andrews, Donglison, from Philadelphia ; Prof. Traill Green, of Eas- 
ton, and all members of the profession from other States, and members 
of District Medical Societies of this State, and the resident physicians 
of Cape May, be and they are hereby cordially invited to seats as 
corresponding members. 

The Committee of Arrangements, through their 
chairman, Dr. Bateman, addressed the Society as fol- 

Gbntlbmen of thb Medical Society of New Jebset : 

At the Annual Meeting held last year at Atlantic City, the Cumber- 
land County District Medical Society extended an invitation to the 
Medical Society of New Jersey to meet this year at Cape May City. 
This invitation was accepted, with a like invitation from the District 
Society of Gloucester, which Society wished to share the honors of the 
occasion with Cumberland. 

A Committee was appointed to carry out the necessary arrange- 
ments for holding the Annual Meeting in this city. 

The Committee have made every effort, as they believe, to render this 
meeting pleasant and satisfactory. Having first secured this celebrated 
place (Congress Hall) for its session, they obtained a free pass from 
and to Camden, through the liberality of the New Jersey Railroad 
Company, and arrangements were also effected with the Pennsylvania 
R. R. of the New Jersey Division, for excursions tickets (at about 
half the usual fare) which will be good until the 29th inst 

This evening at 10.80 there will be a collation and social reunion in 


the drawing-room of the hotel, given to the delegates, their families 
and invited guests, by the physicians of Camberland, Gloucester and 
Cape May ; to which you are all cordially invited. 

On Wednesday, after the adjournment, or whenever it may suit 
your pleasure, Mr. Alexander Whilden, of Philadelphia, has made 
provision to convey the Society and all others present, to the new city 
of " Sea Grove," about one and a half miles distant, which invitation 
80 generously extended, I hope you will accept. 

And now, gentlemen, in the name of the District Societies of Cum- 
berland and Gloucester, and the Medical Society of Cape May, I 
welcome you to this " City by the sea." You have in your annual 
sessions visited Long Branch and Atlantic City, and to day we are 
happy to greet you at this celebrated watering place, at the southern 
extremity of our State. How grand and majestic are its objects 1 
The broad Atlantic and the waters of the Delaware here commingle 
and are studded with commercial canvas from every nation. 

This city, which you have honored with your presence, as a sea-side 
resort, has no superior along the Jersey coast. It is very justly cele- 
brated for 

1st. Its Humidity. 

2d. Its Drinking Water. 

8d. Its Drainage or Sewerage. 

4th. Its Artesian Well. 

5th. Its Organized Fire Department 

6th. Its Magnificent Drives. 

7th. Its Unrivalled Beach. 

8th. Its Temperature. 

From the report of Capt. H. W. Howgate, of the Signal Service, 
we learn that the mean daily temperature of Cape May, Atlantic City, 
and Long Branch, for the months of July, August and September, 
1874, was as follows: Cape May 68.9, Atlantic City 69.2, and Long 
Branch 69.6. This report also represents Cape May as having a dryer 
atmosphere than its rival, Atlantic City, during the hot summer 

These facts render this watering place a desirable resort for those in 
quest of health, as well as for those seeking simple relaxation from 

Dr. 8. S. Marcy, who has been a practicing physician at Cape May 
for the past fifty-five years, says that during the first forty years, he 


never met with an idiopathic case of intennittent fever, when the 
patient resided continaoasly on the Gape, and bnt few cases where 
the individual spent part of his time in this county. He has met 
with no cases among visitors, except in a few instances, where the 
disease could be fairly traced to excess of sea bathing. He also 
states that the typhoid fever is of rare occurrence, and very amenable 
to treatment. During his long and extensive experience, he has 
never known an epidemic of any disease to prevail during the sum- 
mer, and visitors leaving the city on account of affections of the 
alimentary canal, speedily recover after a short residence at this 

To this city, beautiful by nature and by art, with its invigorating 
atmosphere and wonderful resources, its grand hotels and magnificent 
residences, it is my pleasure to bid the Medical Society of New 
Jersey a hearty welcome ; it is our hope that your visit here may 
be among those things worthy to be remembered this Centennial 

Gentlemen, "brethren^ thrice welcome to our hospitality. 

The President read the Annual Address, the subject 
of which was '' External Influences on Medicine." 

On motion of Dr. Bateman, a vote of thanks was 
returned to the President for his able and interesting 
address, with a request that he furnish the Standing 
Committee with a copy for publication. 

The Committee on Medical Ethics and Judicial Bu- 
siness, reported that there had been no business before 
the Committee during the year. 

The Committee on Old Records of this Society, re- 
ported that it had published in pamphlet the records 
of the Society from the first meeting in 1766 to 1800. 

An invitation from Mr. Whilden for the members of 
the Society to visit Sea Grove after adjournment to- 
morrow, was accepted. 

A communication from Dr. J. D. McGill was re- 
ceived, and, on motion of Djr. Pennington, was referred 
to the Committee on Medical Ethics. 


On motion of Dr. Wickes, the President appointed 
Drs. Lilly and Hunt on the Standing Committee, pro 
re nata, as the chairman was the only member in at- 

The delegations of the several District Societies 
named their member of Nominating Committee as 
follows : 

Bergen, H, A. Hopper; Burlington, P, Gaunt; Camden, J. W. 
Snowden; Cumborland, S. Whitaker; Essex, A. Ward; Gloucester, 
P. S. Heritage; Hudson, 8. R. Forman ; Hunterdon, J, 8, Cramer; 
Mercer, J, I. B. Ribble ; Middlesei, C. H. Voorhees ; Monmouth, D, Mc- 
Lean Ponnan ; Morris, D. B. Ajres; Ocean, Gordon; Paaaaic, 

C. P. W. Myers; Sussex, J. Hedges; Union, L, W, O&kle;; Wanen, 
P. F. Brakeley. 

The President announced the Committee, and named 
P. P. Brakely as the chairman. 

The President also announced the following Com- 
mittees : 

Committee on UnJinUhed Biaineii.—'On. Thomason, Oreen, and Cross, 

OommUtee on Treamrer'i A<xounti.—Tita. Arrowsmitb, Voorbees, and 

The credentials and theses of Louis Rein and Ed- 
ward Mueller of Hudson, candidates for the degree of 
M. D., were received and referred to the following 
Committee : 

Drs. Pennington, Hvint, and lally. 

Adjoumed until nine o'clock to-morrow morning. 


The President in the chair. Prayer was offered by 
the Rev. Mr. Garrison, of Camden. 
A petition from Dr. Payne, of Hudson, was received, 


and, on motion of Dr. Lilly, was referred to Committee 
on Ethics. 

The Annual Report of the Standing Committee was 
read by Dr. S. Wickes, the chairman. The report was 
adopted and referred to Committee on Publication. 
A half hour was devoted to remarks upon the report, 
which was occupied by Drs. Hopper, Ridge, A. W. 
Rogers, G-auntt, J. Solis Cohen, and Wm. B. At- 

Dr. Wickes introduced a blank which he said was a 
copy of one which had been used the past year by the 
reporter of the Morris District Society with great ad- 
vantage, and he recommended its use by the reporters 
generally. (See* Appendix, No. IX.) 

Dr. Lilly, to whom was referred the writ of the Su- 
preme Court of New Jersey, read his report, the re- 
commendations of which were adopted. (See Appen- 
dix, No. I.) Drs. H. R. Baldwin and L. W. Oakley 
were added to the Committee. 

On motion of Dr. Lilly, Drs. Lilly and Phillips were 
appointed a Committee to prepare and present to 
Barker Gummere, Esq., some expression of regard for 
the valuable services he has rendered the Society as 
law counsellor. 

The Committee on Dr. Hunt's resolutions, by the 
chairman. Dr. Brakely, reported as follows : 

The Committee to whom was referred the resqjutions offered by Dr. 
E. M. Hunt, in reference to State legislation as to public health, feel- 
ing the subject to be one of vital interest, recommend the following 
resolutions : 

Hesohed, That the prevention of disease so far involves the interests 
of citizens as that it should be a subject of Legislative consideration. 

Sssolvedj That we do not approve of any action by which Health 
Boards are constructed with reference to providing an assortment of 
Physicians of various medical sects. 


Betohed, That anj attempt to constrnct Medical Boards by legiala- 
tiye enactment, of dlfTerent so-called schools, eitha for the purpose of 
Medical Examinations^ or for Health Boards, should not receiTe the 
enconragonent of any memb^ of this Society. 

All of which is respectfnlly salnnitted. 

The resolutions were adopted. 


Dr. Love announced the death of Dr. A. W. Wood- 
hull, a delegate to this Society, and moved that a 
Committee be appointed to prepare resolutions ex- 
pressive of the sentiments of this body His motion 
was adopted, and a Committee consisting of Drs. 
Love, Smith and Cross, being appointed, subsequently 
reported the following, which were adopted : 

Whebeas, This Society haye been informed of the death, on the 
14th inst., of ene of its delegated members, Dr. Addison W. Wood- 
hull, of Newark, N. J., therefore — 

BeaoiDedj That in his death, we monm the loss of one esteemed for 
his intelligent and fidthfal counsels, his discriminating judgment, 
his intellectnal worth, his skill as a physician, and his patriotic aer- 
yices to the State and conntry. 

Be^oivedy That by his death, the conntry, as also the State, loses (me 
of its most yalned citizens, and that, as fellow-members and co-workers 
in the profession, we deeply feel this sad bereayement, and ext^id oar 
sympathies to his stricken family and Mends. 

Betohed, That this expression of the feelings of this Society be 
entered on the minntes, and a copy of it sent to his fiunily. 

Treasurer Phillips rendered his report, which was 
referred to the Committee on Treasurer's Accounts. 
(Appendix No. 11.) The Committee subsequently re- 
ported that it had examined the accounts of the Treas- 
urer, and had found them correct. The Committee 
approve of the recommendation of the Treasxirer as 


to the amount of the assessment for next year. The 
report was adopted. 

Corresponding Secretaiy Elmer read his report. 
(Appendix No. III.) The Secretary mentioned that he 
had received letters of regrets from Drs. Adams and 
Buck, delegates from New York. Both gentlemen 
had intended to be present at this meeting, but were 
detained by sickness. Drs. J. Parrish and Ferris 
Jacobs, honorary members, also sent their regrets. 
The Corresponding Secretary also stated that he had 
received a communication from the International 
Medical Congress, requesting this Society to send dele- 
gates to the Congress to be held in Philadelphia in 
1876 ; also one from the Boston Society of Civil Engi- 
neers, inviting this Society to aid it in memorializing 
Congress to fix a date after which the Metric Weights 
and Measures shall be the only legal standards. 

It was voted to send delegates to the Congress, and 
the Nominating Committee was instructed to nominate 
the delegates. It was voted that Drs. Oakley, Cross 
and Taylor be a Committee to petition Congress to 
establish the Metric system of Weights and Measures, 
in connection with the Boston Society of Civil Engi- 

The Committee on Unfinished Business reported no 

The delegates to corresponding Societies presented 
their reports, which were referred to Committee on 
Publication. (Appendix No. IV.) 

The delegates from corresponding Societies were 
formally presented to the Society, and a cordial wel- 
come was extended to them by the President. Dr. 
Cutler in behalf of Massachusetts, Dr. Wiggins of 


Rhode Island, and Dr. Newman of New York, briefly 

The regular delegates from Pennsylvania having re- 
turned home, Prof. Traill Green, an ex-President of 
the Medical Society of Pennsylvania, was called out, 
and addressed the Society as follows : 

I am happy to meet the gentlemen of the Medical Society of New 
Jersey to-day. I have always found it pleasant and profitable to at- 
tend these meetings. I supposed that I should not be called upon to 
make a speech at this busy period of their session, when so many in- 
teresting questions are being discussed. I endorse the remarks made 
a moment ago by the delegate from New York, " Life is too short to 
make a long speech," and I shall not attempt it. 

I will say, that I am under great obligations to New Jersey and its 
Medical Society. The first gentleman to whom I was introduced, on 
entering life, was a New Jersey physician, and for some years was a 
member of this Society. I do not recollect any of the circumstances 
that were connected with that introduction, but it was a very import- 
ant event in my life. I have from that day to this, with a few excep- 
tions, soon after this occurrence, celebrated it annually. Its anniver- 
sary is now at hand — to-morrow I shall celebrate its sixty-third return. 

Had I taken part in the interesting discussion which you have had 
on the use of calomel, I should have referred to its use by the gentle- 
man to whom I have alluded — my first acquaintance. He was a pro- 
gressive man, and followed the teachings of the schools of his day, 
when the dose called '^ Ten and Ten," (ten grains of calomel and the 
same quantity of jalap) was so much employed in the treatment of 
yellow fever. I would say that I was " brought up" on calomel. I 
was not sickly, but I know this remedy was administered in childhood 
and youth when I was ill. It is related of him, that if his dreams 
were unpleasant at night, he took a dose of calomel the day following, 
supposing that there was some Ainctional derangement which required 
for its correction this medicine. His confidence in its therapeutic 
power, we think, was transferred to others in the community in which 
he lived and pursued his profession. 

He was bold in the use of the lancet. When eighty-seven years of 
age he had an attack of rheumatism. I called to enquire concerning 
his health, and was invited to his chamber. He was glad to see me, 


and said '* Here is Dr. Edward Swift, who declined to bleed me ; 
his brother Joseph bled me seventeen years ago in a similar attack. 
I replied, " yes, doctor, but seventeen years added to a man's life at 
seventy, makes many changes." He said, ^^ Yes, but I know blood- 
letting will do me good." Dr. Swift remarked to me, aside, " I think 
we ought to defer to the doctor's opinion," and he was bled. The 
doctor was deUghted to see the blood flowing from his arm, and 
remarked, *^ Do not stop it, I know it will do me good. I was never 
charged with killing more than three of my patients by blood-letting; 
two are still living, and one died ten years after the operation, from 
want of bleeding. 

Dr. Joseph K. Swift, who was associated with him in practice for 
many years, used to remark, '' Dr. Cooper always treated our bilious 
fever with great success. He carried his patient through his illness 
with great skill." 

I can almost claim membership with you for other reasons. I live 
quite near the line which divides Pennsylvania from New Jersey. My 
father emigrated from the capital of your State to my present home ; 
not because, as it is sometimes said, '^ New Jersey is a good State to 
emigrant from." 

He, like others we find among us in Pennsylvania, was proud of his 
native State. We have had reason to be glad, on the other side of 
the line that separates us, that so many of your citizens have chosen 
our State for their home. They have carried to us professional and 
social qualities, which have been blessings to us. 

I have found intercourse here with the members of our profession, 
profitable ; and I shall carry with me pleasant memories of the meet- 
ing at Cape May. 

Dr. Phillips, reported on the nomination of Dr. 
Weir Mitchell for honorary membership (Appendix 
No. VII.) A ballot was taken, when Dr. Weir Mitchell 
was declared unanimously elected an honorary mem- 
ber of this Society. 

The nomination of Dr. Lutkins for the honorary 
degree of M. D., was by the request of Dr. Morris, 


Dr. J. S. Cook, third Yice- President, read an essay, 
the subject of which was, '' Our climate, and its effect 
upon disease/' 

On motion of Dr. Love, a vote of thanks was ex- 
tended to the Doctor for his interesting essay. 

Drs. R. M. Bateman and E. P. Townsend were 
present, and were prepared with their essays, but for 
want of time their essays were read by title only, and 
referred to Committee on Publication. 

The Committee to whom was referred the theses of 
Mr. Mueller and Rein, reported by its chairman* Dr. 
Pennington, that it had examined the theses and 
found them satisfactory. Mr. Muellers was on 
Chronic Perforating Gastric Ulcer. Mr. Rein, on 
Intermittent Fever. The certiiicates of the President 
of the Hudson District Society, as to the examinations 
of Mr. Mueller and Mr. Rein, were read and were 
deemed satisfactory. A ballot was taken upon the 
theses, which resulted in the unanimous approval of 
the same. The President and Secretary were instruct- 
ed to prepare the diploma, and deliver the same to the 
parties, when they shall have fullilled the further re- 
quirements of the law. 

The Committee on Ethics, bv Dr. Lillv, read its 
report on Dr. McGill's communication, which, on mo- 
tion, was adopted. (Appendix ^o. YTII.'y 

The following bills were presented and ordered to 
be paid : 

Wm. Elmrar, Jr. $24 05 

Wm. Pierson, Jr. IS 00 

P. W. Baldwin. 5 00 

Dr. EL J. Marsh, of Paterson, was appointed essay- 
ist for the next meeting of the Society. 


The Nominating Committee reported, by the chair- 
man, Dr. Blakely, as follows : 

For iVwufone— John V. Schenck. 

First Vice-President — H. R. Baldwin. 
Second " —John 8. Cook. 

Third " —A. W. Rogers. 

Corresponding Secretary— Wm, Elmer, Jr. 
according " — Wm. Pierson, Jr. 

Treasurer— W. W. L. Phillips. 

Standing Committee—Q, Wickes, Samuel Lilly and J. L. Bodine. 
Delegates to the American Medical Association — H. A. Hopper, S. 0. 
Thornton, H. G. Taylor, T. J. Smith, J. J. H. Love, P. S. Heritage, J. 
W. Hunt, Samuel Lilly, E. P. Cooper, J. B. Morris, John R. Leal, H. 
R. Baldwin, Wm. Armitage, Joseph Hedges, John Vought, T. H. 
Tomlinson, P. P. Brakely. 
For Delegate to Medical Society of New Hampshire — C. P. Gordon. 
For Delegates to Massachusetts Medical Society — J. J. Prendergast, J. 
L. Bodine, I. B. James, John G. Ryerson. 

For Delegates to Rhode Island Medical Society— Q, F. Deshler, T. J. 
Thomason, Samuel Lilly, 

For Delegates to Maine Medical Society— Q. H. Balleray, B. D. Car- 
penter, P. C. Gordon. 
For Delegate to Connecticut Medical Society — E. J. Marsh. 
For Delegates to New Torh Medical Society— 'K, B. Silvers, H. Mitchel, 
Jos. Parrish, E. Marston. 

For Delegates to Pennsylvania Medical Sodetj/'-G. H. Voorhees, H. 
C. Clark, Wm. Elmer, Sr., Wm. Blundell. 

For Delegates to the International Medical Congress — J. M. Ridge,' 
John Woolverton, Ezra M. Hunt, John C. Johnsou, Charles Hasbrouck, 
Abram Coles, A. A. Lutkins. 

The Committee recommend that hereafter no enter- 
tainment be given the Society at the place of meeting. 
The Committee also recommend that the next annual 
meeting of the Society be held in Trenton. 

The Society elected, by ballot, the ticket as nom- 


The delegates were elected as reported by the Com- 
mittee, by a viva voce vote. 

The recommendations of the Committee were 

It was ordered that the hour of the next meeting be 
at 7.30 oclock, P. M. 

Drs. C. Shepherd, J. L. Bodine, Charles H. Dun- 
ham, John Woolverton, W. W. L. Phillips and R. R. 
Rogers were appointed a Committee of Arrangements 
for the next annual meeting. 

Dr. Lilly gave notice that he should offer the follow- 
ing amendments to the by-laws, at the next annual 
meeting, provided the proposed amendment to the 
charter should be enacted : 

Chapter I., Sec. 4. Substitute for the present subdiyision " llth,*' 
the following, viz : 

^' llth Communications or propositions from any District or County 
Society ; complaints, memorials, petitions and appeals from any such 
Society, or from any member thereof, and the hearing and determina- 
tion thereof by the Society, or the reference thereof to a committee to 
hear and take proofs respecting the same, and report said proofis with 
their opinion thereon to the Society; and other miscellaneous busi- 

Chapter IL, Sec. 7, after word " whole," line 9, on page 12, insert 
the following, wit : 

'^The said committee shall summon the Society and parties con- 
cerned to attend before them, and shall take the proofs offered on 
either side pertinent to the issue, and hear the statements or arguments 
of the parties thereon, and shall then make up their report and pre- 
sent the same to the next regular meeting of the Society." 

And on same page, line 4, after word " all," and before word " ap- 
peals," insert the following, to wit : 

<' Complaints, memorials, petitions, and " 

And on line 5, same page, after word ^' Societies," insert the follow- 
ing : 

" Or any member thereof." 


On motion of Dr. Oakley, the following were 
adopted : 

Besolved^ That the hearty thanks of the members of the Medical 
Society of New Jersey and guests here assembled are due and are 
hereby tendered to Gen. W. J. Sewell, Supt. of the W. J. R. R. Co., for 
the courtesy extended to them by the road which he represents, in 
conveying them to and from their place of meeting. 

Ee8olved, That we fully appreciate the kindness of the Company, 
and that it has our best wishes for its prosperity. 

Beaohed, That the Society hereby express their thanks' to the medi- 
cal men of the counties of Cumberland, Gloucester and Cape May, 
and the Committee of Arrangements, for all their kindness and hospi- 
tality during the meetings of the Society. Also to Mr. Alex. Whilden, 
for his invitation to visit Sea Grove. 



Becording Secretary, 


• • • 


To the Medical Society of New Jersey : 

The undersigned, to whom was referred the writ of the Supreme 
Court of New Jersey, received at the last meeting of this Society, with 
power to act for the Society, and if necessary to employ counsel, re- 
spectfully reports : 

That immediately after the adjournment of the Society, he applied 
to an eminent legal gentleman for information as to what was required 
by the Supreme Court, and how best to comply. He would here state 
that he understood the wishes of the Society to be to avoid, as far as 
practicable, becoming a party to the unpleasant controversy which has 
arisen between the members of the District Medical Society for the 
County of Hudson, aiming only to maintain the dignity of the State 
Society and keep freed &om contempt of the Supreme Court. 

The information received was that a return in proper form must be 
made to the writ, and that the service of an attorney familiar with 
the practice of the Court would be required. Your committee there- 
upon employed an attorney, who after considerable labor owing to the 
imperfect condition of the documents of which it should be composed, 
made the proper return within the time prescribed. The plaintiff to 
the writ. Dr. B. A. Watson, through his attorney, filed his reasons — 
seventeen in number — for his action. Your committee, deeming the 
case one of great importance to this Society, and probably involving 
considerable expense to properly carry it on, requested that a meeting 
of the ofi&cers. Standing Committee, and such Fellows and other emi- 
nent members of this Society as could be conveniently, reached should 
be called for consultation. The meeting was held, and after a full 
discussion, your committee was advised to retain eminent legal counsel, 
lay the whole case before him, and proceed in accordance with the 
advice he might give. Your committee accordingly retained Barker 
Gummere, Esq., of Trenton, to manage the case. 


Shortly after this, two additional writs of certiorari were issued by 
the Supreme Court, involving the same controversy. Your committee 
was requested to acknowledge the service of these writs, and consent 
to the same return being filed as in the former case. This he declined, 
feeling that he had no power to act for the Society except in the case 
specially referred to him. He has learned, however, that the additional 
writs were served on the President of this Society, and by him referred 
to the attorney in the former case. 

The three cases were argued before the Supreme Court at its last 
session ; a decision may be expected at the coming term, which com- 
mences on the sixth of June (two weeks from to-day.) What it will 
be, it is of course impossible to tell, but our legal adviser predicts that 
it will be substantially in favor of the acts of this Society. 

In view of the difficulties to which this Society may be exposed, as 
demonstrated in the case in hand, Mr. Gummere, with a view to their 
avoidance in the future, advises that a supplement to the charter of 
the Society shall be obtained from the next Legislature, more clearly 
defining its powers and duties, and that the By-Laws be so amended 
as to conform thereto. A draft of such supplement and amendment to 
By-Laws, prepared by Mr. G., is herewith submitted. 

Your committee would respectfully suggest, that this whole matter 
be referred to the same or some other committee, with power to act 
for the Society, to procure the enactment of the supplement, to attend 
to the suit now pending, and any other that may be commenced, with 
power to employ legal counsel if necessary, &c. The Treasurer of the 
Society has paid the attorney employed to make return to the writ, 
and who also assisted in the preparation and argument of the case, 
for fees, expenses, &c., $50, for which he will present voucher. 

All which is respectfully submitted. 

Cape May, May 23, 1876. SAM'L LILLY, Committee. 




To the Medical Society of New Jersey : 

Your Treasurer begs leave to report that he received daring last 
year from all sources, $090.00, as follows : 

Monmouth $50.00 

Hudson S4.00 

Morris 50.00 

Burlington 44.00 

Essex 106.00 

Camden 52.00 

Passaic : 60 .00 

Middlesex.... 36 00 

Bergen 32.00 

Gloucester 22. 00 

Mercer 63 00 

Cumberland 34.00 

Ocean 18.00 

Hunterdon : 36.00 

Union •. 74.00 

Warren 32.00 

Sussex 52.00 

Diploma Fees '- 30 . 00 

Hudson (J.E. Culver) 88.00 

Advertisements • 30,00 

Total $990.00 

There has been expended $901.18, as follows: 

Wm. Pierson, (Rec. Sec'y,) $13.00 

Wm. Elmer, (Cor. Sec'y,) 5.83 

J. M. Reuck, (Programmes,) 7.00 

S. Wickes, Chairman, (Transactions,) 491 .04 

S. Wickes, Chairman, (Expenses,) 15.51 

John Lilly, (Attorney,) 50.00 

S. Wickes, Chairman, (Supplement,) 805 . 30 

Murphy & Bechtel, (Notices,) 1.50 

J. M. Reuck, (Certificates,) ^^-QQ 




Balance on hand $88.82 

In Sayings Fund t,542.03 

Total on hand $1,630.84 

Your Treasurer would recommend the annual assessment to be con- 
tinued at $2.00 per capita. 

WM. W. L."PHILLIPS, Treasurer. 

[APPENDIX No. ni.] 


Tbbnton, May 22, 1876. 
To the Mediaal Society of New Jersey : 

The Corresponding Secretary would respectfully report, that he has 
attended to the regular duties devolving upon him during the year 

The Transactions for 1875 were duly received and distributed in the 
usual manner — to ^honorary memj3ers, to some of the medical journals, 
and to other sister Societies. We have this year had the pleasure to 
receive in exchange the printed Transactions of every State Society 
except for Vermont, Rhode Island, Missouri and Nebraska; and as 
some of these make only biennial reports, it is probable that we shall 
next year reciprocate with all the States. As the inspection and 
comparison of the different State Societies' proceedings may prove 
interesting and profitable to the members present, they have been 
placed before you at this meeting for your convenient perusal. 

In this Centennial year ou]^ Society refers with just pride to the fact 
that our State Medical organization antedates by a decade our national 
independent existence. It was therefore deemed proper that the sup- 
plement, containing the '^ Rise, Minutes and Proceedings of the New 
Jersey State Medical Society, established July 23, 1766," from 1766 
to 1800, affording authentic documentary evidence of our being the 
oldest State Medical Society in existence, should receive a general 
distribution throughout our sister Societies. Copies have accordingly 
been sent by the Corresponding Secretary to nearly all the States, and 
also to the leading representative journals in the various portions of 



the Union. From the latter, favorable editorial notices have mnee 
appeared in their colamng. 

The following official communications have been receiyed, and are 
herewith submitted to the Society for its action : 

(A.) A request from the Boston Society of Civil {^Engineers, to 
aid in petitioning Congress to ^* enact that, after some date to be 
fixed several years in advance, the metrio standard in the office of 
weights and measures at Washington, shall be the sole authorized 
public standard of weights and measures." 

(B.) A request from the President and Secretary of the Interna- 
tional Medical Congress, to be held in Philadelphia, in September, 
1876, that we appoint delegates from this Society to represent us in 
that body. 

(C.) A request from Dr. J. M. Toner, of Washington, appointed by 
the Executive Committee of the International Medical Congress, to 
prepare a paper on Medical Biography, for brief sketches of the notable 
practitioners of our State during the past century. This has been 
referred to Dr. S. Wickes, who is at present engaged in preparing the 
biographies of the physicians of New Jersey, and by whom the de- 
sired information was kindly furnished. 

Respectfully submitted. 

W. ELMER, JR., Cor. Secretary. 


Report of the Delegate to the Rhode Island 

State Medical Society. 

To the Medical Society of New Jersey : 

Your delegate to the Medical Society of the State of Rhode Island, 
would respectfully report : 

The Society convened in the city of Providence, June 9th, 1875, 
this being its sixty-fourth annual meeting. Their annual meetings 
were represented as not being as full of medical interest as were their 
quarterly ones, being more given to financial settlements and social 
interchange of courtesies. I was much pleased with the fact of the 
senior members of the profession constituting a Board of Censors, to 


whom the greatest respect was shown. It was a pleasing exhibit, see- 
ing a given number of those veterans of the profession, with cultivated 
dignity, presiding over and guiding the affairs of their Society. 

The orator of the day delivered a well written argument on higher 
requirements of preliminary study being necessary to well fit candi- 
dates for the study of our profession— (citing one Eastern Medical 
College where the degree of A. M. was essential ^before attending 
Medical Lectures.) 

I am well satisfied that this is a step in the right direction. A mind 
well disciplined by previous study best fits every one to profitably 
hear and retain medical instruction, and would add largely to the 
renown of our profession. 

If to this was added care in the selection of our remedies, so that 
the most concentrated and palatable ones alone were used, a commend- 
able and effectual blow would be given to the so-called Homoeopathic 

The plan of placing each State delegate under the special care of a 
member of their Society, adds largely to the pleasantness of the 

Their annual dinner was truly allopathic in its provisions, and 
with the atmosphere of intimate sociality which prevailed, made your 
delegate feel that the Rhode Island Medical Society knew how to 
make visitors feel as if he was indeed among brethren. 

Respectfully submitted. 


[APPENDIX No. v.] 

Report of the Delegate to the Medical Society 
OF the State of Pennsylvania. 

Your delegate to the Medical Society of the State of Pennsylvania, 
would respectfully report : 

That the last annual meeting of the Society being the 26th, was 
held in Pottsville, on June 10th, 11th and 12th, of which Dr. Wash- 
ington L. Atlee, of Philadelphia, was the presiding officer. The 
President's Address was delivered on the evening of June 10th, in 
Union Hall, and was listened to by a large audience of ladies and 
gentlemen. The subject was " Old Physic and Young Physic," in 


which the changes of half a century were compared and contrasted. 
In this comparison, it cannot be said that Toung Physic appeared to 
any special advantage. 

The address on Practical Medicine, was prepared by Dr. William 
Pepper — an honorary member of this Society — and was an exhaustiye 
and highly practical review of the progress and present condition of 
this department of medical science. 

The address on Surgery, was by Dr. Richard M. Levis, and was de- 
voted exclusively to the consideration of fractures of the lower end 
of the radius. The author denied the existence of the fracture ori- 
ginally described by Barton, and known as Barton's fracture ; and 
declared that it was the fracture first revealed by Collis, and known 
CoUis's fracture. 

The address on Hygiene, by Dr. Benjamin F. Lee, of Philadelphia, 
was, without doubt, the ablest literary production presented to the 

Dr. Curwen, of Harrisburg, read the address on Mental Diseases, in 
which the author took high ground that the overtaxing of children 
at school, without a proper moral training, was a fruitful cause of 
insanity in the young. 

A paper, read by Dr. O. S. AUis, on the Proper Administration of 
Ether, and another by Dr. Lawrence TurnbuU, on the Disorders of the 
Eustachian Tube, were of practical value, and are published in the 
transactions of the Society. 

The social features of the Convention were of a very high order, 

and in receptions, banquets and railroad excursions, your delegate 

spent three of the most delightful days of his life. 

HiQHTSTOWN, May 23, 1876. 


Report of the Delegates to the New Hampshire 

State Medical Society. 

Your delegate to the New Hampshire Medical Society would re- 
spectfully report : 

The Society convened in the city of Concord, June 15th and 16th 
1876— -this being its eighty-fifth annual meeting^Dr. Nahum Wight, 



Preddent, in the chair, who presided oyer the proceedings of the 

Society with dignity and promptness. 

Morning session was called to order at 11 o'clock A. M. ; the first 
hour was occupied in the appointment of committees, resolntions, re- 
port of council and introduction of delegates, who were cordially 
received and inyited to participate in the proceedings of the Society. 

The President read the annual address ; also orations were read and 
papers by visiting physicians. 

The afternoon session was devoted to reports of committees. 

At the evening session a paper was read on Sanitary Measures, 
followed by a general discussion, which finally centered on the causes 
of Typhoid Fever. 

The morning session of the second day was occupied in election of 
officers and the general routine business of the closing session. The 
meeting was not largely attended, but earnestness and enthusiasm was 
evinced in all the proceedings. The papers were meritorious, showing 
study and care in their production. This Society at their annual 
meetings appoint orators and essayists, a custom which impressed 
your delegate as inviting a display of oratory, competition and criti- 
cism. CHAS. O. GORDON. 


To the Medical Society of New Jersey : 

Dr. 8. Weir Mitchell is a son of the late Dr. John R Mitchell, Prof, 
of Theory and Practice of Medicine, in Jefferson College, of Philadel- 
phia. Dr. M. received the early part of his medical education in that 
institution, where he was a most industrious and careful student. 
After graduating he went abroad, and spent ten years imbibing 
knowledge from some of the most celebrated European teachers. 
Upon returning, he commenced general practice, and devoted much 
lime to experimental physiological work and research. He from time 
to time published important papers on this branch of medicine, which 
attracted the attention of the medical and scientifie world. During 
the war, together with Drs. Munhuen and Keer, of Philadelphia, he 
was placed in charge of a hospital for nervous diseases and injuries, 
by Surgeon General Hammond. The experience here acquired was 
from time to time presented to the public, and also led to the publica- 



tion by these gentlemen jointly, of a work on ^^ Gunshot wounds and 

other injuries of Nerves." Of this work, a leading British journal 
says that it is valuable to practical surgeons from the many details of 
treatment which it contains, and that it is ^' specially interesting " to 
physiologists and nerve-pathologists, from the extreme care with which 
the cases appear to have been observed, the exactness and minutenes* 
of the description of the effects of the injunes on motion and sensations 
He has published valuable articles on reflex paralysis, or post paralytic 
chorea, and many other papers on similar subjects, which have been of 
great value to the profession. 

In 1872 he published a work on " Injuries of Nerves, and their Con 
sequences." This work was based chiefly on the author's own re- 
searches. The British and Foreign Medico-Chirurgical Review says : 
*' It is the first complete treatise on this subject the English language 
has been in possession of," and adds, ** it is written not only up to the 
present time, but in many respects far in advance of it," to be referred 
to, now and in the future, "with the utmost confidence and 

Prof. Gross says : " The publication of this production'may be con- 
sidered as forming a new era in the history of these diseases. Up to 
that period the whole subject was involved in mystery, and it was 
only by studying it in the light of clinical experience that it was suc- 
cessfully unraveled. The work of Dr. M. is founded on the careful 
observation and analysis of several hundred cases of injuries to nerves, 
and upon numerous experiments performed on animals with a view of 
determining the physiological question of the influence of pressure on 
nerves, elongation and separation. Of this treatise it is not too much 
to say that it constitutes one of the most valuable contributions to the 
medical and surgical science of the present day. Ever since the date 
of its publication, lesions of nerves have been regarded from a new 
stand-point." Dr. M. has also carefully investigated, experimented 
and reported upon the subject of snake-bites. 

These researches have been published by the Smithsonian Institution. 
The Doctor has occasionally contributed articles to our literary maga- 
zines which have in no wise detracted from his well-earned reputation. 
We believe it is unnecessary to detail any further the labors or merits 
of Dr. Mitchell. The members of this Society have sufficient knowl- 
edge of them. The. Doctor is still at work; he occupies no public 
position except that of Trustee of the University of Pennsylvania, and 



Consulting Physieian to the Hospital for treatment of nerve diseases 
in Philadelphia, of which he was one of the founders. He is not a 
teacher in any of the schools ; his sphere as a teacher has not thus 
been circumscribed ; he has been the instructor of our whole profes- 
sion. Let us do credit to our Society by electing him an honorary 
member, knowing full well that the honor derived from the act will 
be reciprocal. 


ROBT. W. ELMER, } Committee. 



To the Medical Society of New Jersey : 

Your Committee on Ethics, to whom was referred the communica- 
tion of Dr. J. D. McGil, would respectfully report : 

That the communication complains of the report of a case of 
Aneurism of the Aorta, made by Dr. H. Mitchell, and published in 
the transactions of this Society for 1875. Your committee beg to say, 
that this Society does not hold itself, or its Publication Committee, 
accountable for the correct report of clinical cases sent us by the Re- 
porters of the District Societies. They only are responsible for the 
correctness of their reports, although it might be proper for us, in case 
of an unmistakable reflection upon professional practice, to ask the 
Reporter or his District Society to make correction. We have no 
reason in this case to regard the allusion as an intended reflection by 
its author, and assure the complainant that no member of our So- 
ciety has designed the least reflection upon his professional diagnosis. 

Your committee therefore recommend the adoption of the following 
resolution : 

Boohed^ That the Secretary of this Society be directed to forward 
to Dr. McGill a copy of this report. 

Respectfully submitted, 


S. WICKES, > CommiUee. 
E. M. HUNT. 
Mat 24, 1876. 

T. ) 



, N. J., , 187 


Please fill out the following blanks and return to me, before the 

the inst. By so doing, you will add to the material from which 

to make a report, reflect credit on the Medical Society of which yoa 
are a member, and greatly oblige. 

Very respectfidly, 


E^NoTE. — ^Answers are not limited to the space allotted. If 
necessary, write on another paper bearing the number of the question 
thus answered. 

" A." (1.) To what extent have the diseases peculiar to the seawM 
prevailed, as compared with premous years ? 

"A." (2.) Have any of the diseases of this character assumed a 
peculiar or unusual type f 

"A." (8.) Have you anything new or of inUrevt to relate in refer- 
ence to \ht pathology or t/reaiment of this class of affections ? 

^'A." (4.) Has the death raU from any of this class of diseases 
been unusually high, or lowt 

" B." (5.) Have epidemics of any kind prevailed ? 

"B." (6.) Write anything of interest in relation to the cause, 
pathology^ symptoms or treatment, 

" B." (7.) What was the rate of mortality f 

" C." (8.) If an endemic of any kind has occurred, write a full 
clinical history, (at least of a typical case) the supposed cause, the 
pathology, treatment, and a description of the conditions under which it 

" C." (9.) What was the raU of mortality t 

" D.'' (10.) Of the so-called contagious or infectious diseases, (ex- 
clusive of Variola) which have prevailed ; and to what extent ? 

**D.'' (11.) Have any of the diseases of this class assumed a 
strongly m4ilignant type, or been frequently complicated with some other 
disease, or followed by trovbUsome or undesirable sequeiUs t 


" D." (12.) What was the faU of mortality of eaek f 

"E." (13.) Have you met with cases of Variola^ or V<vrioUnd t 

"E." (14.) How many? 

"E." (15.) Number of deaths ? 

**E." (16.) Of the children under four yearB of age^ can you make 
some estimate of the proportion unproieeted by vaeeinaUon f 

"P." (17.) Including deaths/iY>»» every cause, for the year ending 
April 1st, 187 , how does the mortality compare with that of previaue 

"G." (18.) Will you give your experience, in the use of any of 
the so-called new remedies in the treatment of disease f 

'^ H.'* (10.) If you have a ease or eases of special interest to report, 
please name the stibjeet in this paper, and send me a ftdl history of the 
same before the Fifteenth day of ApriL 



Add after Resolutions on pag^ 22 : "The Committee also stated that 
there had been placed in their hands, to be read before the Society, a 
Memoir of Dr. Woodhull, prepared by Dr. E. Holden, of Newark; 
which paper they recommended be referred to the Standing Com- 
mittee, with power to publish the whole or such parts of it as the 
Committee should deem best 

" Moved by Dr. Love —That this recommendation of the Committee 
be adopted. Motion carried." 


Oentlemen of the Medical Society of Neuo Jersey : 

Medicine to-day is not regarded as one of the exact 
sciences ; even physicians make only a halting claim, 
when they style their profession the art and science of 
medicine. Whatever its actual or relative position in 
the scientific scale may be, there can be no question of 
its growth and vitality. From an empirical infancy, it 
has grown "so great that it makes animate and inanimate 
nature alike subservient to its needs, and tasks for its 
benefit all pursuits and all sciences. Its great growth, 
however, has been from within, and this inner growth 
has been a real and healthy development. Whenever, 
and wherever, outside influences were permitted to guide 
or govern, its apparent progress has proved to be false 
and fictitious. To a greater extent, perhaps, than 
other sciences, it has been acted on by external in- 
fluences — philosophy, metaphysics and physics have 
alternately taken it in charge, causing it to deviate 
from the true course, retarding and fettering real pro- 
gress. In this year of retrospect, it may not be out of 
place to look back, and take a cursory glance at the 
more prominent and continuous of these external influ- 
ences. This review must necessarily be of the most 
superficial character, skimming along the surface of 
the history of medicine, and only pausing where 
some larger obstruction throws a longer and deeper 
• shadow. 

The early growth of medicine was very slow ; and 

president's address. 43 

this slow growth was not an accident, but is the attri- 
bute and essence of all physical science. In this 
respect, literature and art are opposed to science, and 
seem to require for their growth and development, 
very different conditions. Wars, political struggles, 
social revolutions, religious strife, have been the stim- 
uli of literary progress. Such subjects are the inspir- 
ation or the theme of the orator, poet and historian. 
The classic models of early Greece, were but the lite- 
rary sparks, struck out by the collisions of its many 
little republics. The foreign conquests and intestine 
strifes of ancient Rome were crowned in its Augustan 
age. The two most illustrious epochs in English litera- 
ture were preceded, the one by the reforihation, the 
other by the second revolution. The military glories 
of the reign of Louis the XIV. of France were accom- 
panied, and are now eclipsed, by the literary glories of 
his time. The dawn of modern German literature broke 
on the nation during its deadly struggle for existence 
with the empire of the first Napoleon. Every national 
literature, worthy to be named, has had a stormy cra- 
dle for its infancy. 

While literature and art are b ut the outward expres- 
sion, science is, as it were, the inner life of the 
material world. Like the precious metals, it is below 
the surface, and requires fixed thought and plodding 
labor to bring it to the light. Excitement and conten- 
tion are antagonistic to its growth. It loves an atmos- 
phere of silence, and like the grand forces of nature, 
works slowly, noiselessly and unseen, except in its 
results. Its direction is rather influenced by the intel- 
lectual under-current of the period, than by political 
or social changes. 

In the history of civilization there may be recognized 


three grand periods or stages of scientific develop- 
ment : Estheticism, or the period of philosophy ; 
Metaphysicism, or the period of supernaturalism ; and 
Physicism, or the period of physical science. 

All three have, no doubt, existed since civilization 
began; but the predominance of one or other at 
different times, marks the epoch. Philosophy and 
metaphysics have ceased to be active forces in the 
world of intellect ; their empire over the human mind 
has passed or is passing away. Ancient philosophy is 
dead, and would long since have lapsed to utter decay, 
but for the subtle spirit of genius, which once in- 
formed and still preserves it. The doctrines of medie- 
val metaphysics still linger in our schools ; their 
authority disputed, their domain abridged by the 
overwhelming progress of physicial science. 

In the first glimpses that we obtain of medicine, 
either in sacred or profane history, it is associated 
with religion. Priests were its professors, and natural 
and supernatural agencies were mixed together in a 
sacred mysticism. When liberated from this monop- 
oly of caste, and secrecy of hieroglyphics, it became 
associated with the philosophy of the day, reflecting 
to some extent, one or other of the prevailing doctrines 
of the hour. And now began its age of Estheticism, 
which may be said to extend from the dawn of 
Q-recian civilization, to the fall of the Roman empire. 

As the religions of this period looked upon the 
practice of human anatomy as a desecration of the dead, 
a crime to be visited by the severest punishment, a 
knowledge of anatomy could be only comparative. 
Physiology became a subject of the cradest and wild- 
est speculations. Pathology was unknown. Indeed 
it was maintained that such subjects, being as it were 

pbesident's address. 46 

hidden mysteries, it was impious to pry into the 
secrets of the Deity. A shadow of the same spirit, it 
would seem, has descended to the present day ; but 
now, instead of boldly prohibiting the inquiries of 
science, it is reduced to the weakness of refusing to 
accept the inevitable conclusions. 

The study of the asx)ect and outward forms of 
disease, was the only true work left to the physician. 
Such work was in harmony with the int-ellectual ten- 
dency of the times. The cultivation and even worship 
of all forms of external beauty, grace and strength, 
was the passion of the age, and sculpture, and painting, 
and poetry, were devoted to this end. The medical 
writings of this period, that have descended to us, have 
been conceived and executed in the esthetic spirit. 
The works of Hippocrates, Areteus and Celsus are 
models of descriptive disease. Modern minuteness 
may have here and there been able to add an additional 
touch, but the bold outlines as drawn by these master 
hands, are still as true to nature as they were two 
thousand years ago. Many of their descriptions have 
been abbreviated into current phrases, by which a few 
words are made to represent a perfect picture. 

Co-existing with, or more properly speaking, an ex- 
tension of this worship of external beauty, was the 
desire and longing of the mind after abstract beauty. 
Thereupon rose systems of philosophy which specu- 
lated on man' s moral and material nature ; on the 
analogies of the vital forces which maintain life, and 
of the physical laws which control the world of mat- 
ter; on the harmonies of soul and body, of earth 
and stars. Pythagorus took even a higher flight, and 
with a fanciful , yet sublime ideality, aspired to hear 
and interpret the music of the spheres. 

1. •• »T- 'i. . 


TTL-^ L* —II i SL^ 

••.^""i. *•— 

( w . 


t « 

» _^ ^ 

t «. 

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pbesident's addbess. 47 

instrnment of power — ^intellectual superiority. As 
captive Greece is said to have subdued her Roman 
conqueror, so Rome in her own turn of servitude cast 
the fetters of a moral captivity on the fierce invaders 
of the North. ' ' This influence extended from the hut of 
the peasant to the palace of the prince. It began with 
the first consciousness of life, and only terminated 
within the shadow of the tomb. It directed education, 
guided the policy of statesmen, controlled kings, col- 
ored and overshadowed all the intellectual efforts of 
the time. 

Medicine sank under the general yoke. As it was 
formerly an appendage to philosophy, it now became a 
species of religion. Th e religious orders monopolized it. 
The speculations of Plato and Pythagoras gave place to 
the visions and'reveries of the devotee and fanatic. Dis- 
ease was looked upon as a visitation of the anger of 
the Almighty, and faith and prayer were esteemed the 
remedies capable of averting or removing the infliction. 
This simple reliance on the Deity soon degenerated to 
beliefs and practices alike abhorrent to science and to 
religion. Charms and divinations — fragments of dead 
creeds— were raised up and rehabilitated in Christian 
guise. Demonology became an assured article of 
popular faith, and, as in Ancient Mythology, each 
river, grove and plain, had its tutelary demi-god, so 
in the medical philotheism of the Middle Ages, each 
particular disease was placed under the charge of its 
special demon. This phase of medical superstition 
long retained a hold on popular credulity, and it is 
only within the memory of some still living, that cer- 
tain forms of cerebral disease ceased to be considered 
as evidences of demoniac possession. The belief which 
deprives man of personal responsibility, whether it be 


the belief of superstitious ignorance or fanatical refine- 
ment, takes from him all incentive to independent 
thought and action, and tends to throw him into a 
lethargy of mind and body. Into such lethargy was 
the practice of medicine plunged. From such torpor 
there could have been no awakening, had not the hand 
which administered the bane supplied the antidote. 
The religious orders established Medical Schools — the 
earliest and best known at Sarentum and Naples — 
where the relics of ancient medical knowledge were 
cherished, and the more recent Saracenic additions of 
fact and commentary heartily welcomed. Prom these 
centres emanated the first faint streaks of light, har- 
bingers of the coming dawn. The earlier rays of 
science, however, were tinged and refracted by the 
media through which they passed. Astrology and 
alchemy, which now arose, occupy a middle place 
between supernaturalism and science. These pseudo 
sciences required observation and experiment, and 
while the object was delusive, the method was correct. 
Their ascendancy marks the first step from pure super- 
naturalism to scientific research. 

Medicine, no longer passive and supine, dares to in- 
vestigate and interpret, becomes imbued with fresh 
life and enters on a new phase of existence. No longer 
the mere instrument of a predominant infiuence, no 
longer absorbed in philosophy, or oppressed by super- 
naturalism, it assumes a more independent position, 
looks abroad and applies or appropriates every new 
discovery in mechanics or mathematics, in the physi- 
cal and even in the abstract sciences. 

Sciences are social, related and inter-dependent. 
Their mutual contact and inter-locking are too evident 
to need illustration or assertion. Even poetry, which 

president's address. 49 

has not advanced any claim to be enrolled as one of the 
exact sciences, is considered by Cicero to have some title 
to recognition. Advocating the claims of the poet 
Archias to Roman citizenship, on the ground of literary 
eminence, the orator not only asserts that poetry is enti- 
tled to scientific fellowship, but proclaims, in a sweep- 
ing generalization, that all arts, ministering to the 
wants of man, are bound together by the bonds of 
kindred. " Etenim omnes artes quae ad humanitatem 
pertinent, habent quoddam commune vinculum, et 
quasi cognatione quadam, inter se continentur." To 
common sight, poetry and science appear as far apart 
as the poles. It would seem as if between them there 
could be neither contact or communion ; and yet re- 
cent discoveries have disclosed the fact that in many 
instances the poet had, by the intuition of genius, an- 
ticipated the slow research and patient labor of science. 
The atomic theory of Lucretius, which remained 
dormant for two thousand years, is now being hatched 
into light and life under the incubation of Tyndall. 
Even anatomy, the most practical and prosaic of all 
pursuits, is indebted to the imagination of Goethe, 
who insisted on the existence of an intermaxillary bone 
as necessary to complete the harmony of anatomical 

We now come to view medicine in its association 
with modern science ; and this association presents 
itself under two opposite if not hostile aspects. Under 
the firsti science attempted to explain vital phenomena 
by material laws ; under the second, medicine employs 
the resources of science to aid in the discovery of vital 
laws. This present age is brilliant with physical dis- 
coveries ; matter has been analyzed to its simplest 
forms, and the laws and forces which govern the atom 



in its separation, or in its hugest aggregations, have 
been established. As each fresh discovery burst on 
the world, the medical theorist laid hands on it, and 
attempted to solve the shifting mysteries of life, health 
and disease, by the established laws of matter. There- 
upon arose all kinds of theories — mechanical theories, 
mathematical theories, electrical theories, chemical 
theories — which shifted, changed and re-formed with 
the endless and fantastic variety of the pictures in a 
kaleidoscope. Most of those theories are dead ; -a few 
at best retain a questionable vitality. In the hurry to 
find a key which would unlock the secrets of life, the 
principle of life, the vital principle, was overlooked. 
This error pervaded all the earlier scientific biological 

This error still lives. Electricity and chemistry are 
still called on, not only to elucidate but supplement 
the action of the nervous system ; *not only to explain 
but supplant the process of digestion. All the known 
laws of all the known sciences, have been in turn 
applied to explain the phenomena of life, and all have 
successively failed. Failure never brings despondency. 
The attack is renewed under a new form, and the bat- 
tle still goes on between the principle of life and the 
laws of matter. 

The application to medicine of the systems of phi- 
losophy, of the dreams of supernaturalism, and of the 
laws of physical science, have been all alike an error 
and a delusion. Philosophy and supernaturalism can- 
not be accepted as guides, as medicine is a physical 
science. The physical sciences cannot be permitted to 
control, as the physicism of medicine is tempered by 

Medicine is then a special and to a certain extent an 
independent science. 

Peesident' s address. 51 

It has its method of learning, its isolated facts, its 
general laws. It is the science of observation. It is 
built, case upon case, fact added to fact, and when the 
same phenomena occur under the same conditions, 
we can draw our induction with a certainty as unerring 
as calculations based on established physical laws. The 
uncertainties of practice are not in the science, but in 
ourselves ; in our failure or inability to observe or ap- 
preciate the main and modifying conditions. The 
profession is now working in the right way to attain a 
correct interpretation of the phenomena of health and 
disease. A more than scientific accuracy of observation 
is required, as there are so many modifying powers, and 
a high philosophic capacity for generalization, so that 
each force and condition be allowed its full weight in 
the final estimation. 

What we know positively, is simple, direct and lu- 
minous ; imperfect knowledge is confused, involved 
and theoretical. Old Homer threw protecting clouds 
around his weak-kneed warriors ; we envelop in theory 
our defective science. Lord Bacon, in his work under- 
taken for the advancement of learning, thus character- 
izes unbaaed scientific speculation : " For the wit and 
mind of man, if it work upon matter, which is the con- 
templation of the creatures of God, worketh according 
to the stuff, and is limited thereby ; but if it work upon 
itself, as the spider worketh his web, then it is endless, 
and brings forth indeed cobwebs of learning admirable 
for the fineness of thread and work, but of no substance 
or profit." 

We now come to look at the association of science 
with medicine under the second aspect — that of an 

While science cannot be acknowledged as a despot 

president's address. 53 

tematic order the physical conquests already achieved. 

The modern scientist may not be able to see the 
present connection, or trace the distant association of 
each scientific fact as it comes to light. He has, however, 
an abiding faith that science, like time and space, is 
indefinite and can have no limits. The chemist and 
microscopist had no more idea of the extensive field of 
future research, which their minute labors were open- 
ing for their successors, than had the inventor of the 
mariner's compass any thought that his despised in- 
vention would disclose a new world for the benefit of 
future generations. 

''They builded better than they knew." They laid 
the solid foundations of a new philosophy of medicine : 
a philosophy such as Bacon foreshadowed, and Des- 
Cartes initiated. A philosophy founded on physical 
truth, and built up by scientific induction ; a philoso- 
phy not of leaves, but of fruit ; not of theory, but of 
fact ; the philosophy of modern sanitary science. 

This new philosophy lifts our profession from detail 
to generalization ; from the individual to the community. 
It may be compared to the modern science of war. 
Individual prowess counts for nothing — victory being 
organized before the forces take the field. State medi- 
cine or sanitary science, in like manner, anticipates 
the coming of disease, knows its favorite haunts, and 
the conditions necessary for its propagation — meets it 
here with closed gates, cuts off its supplies there, 
either repelling or reducing it to inaction or forcing it 
to die of inanition. This philosophy is still in its in- 
fancy, with the promise of a fruitful future. If the 
work of the present day be any indication of the com- 
ing triumphs in this direction, the time may come 
when hereditary and moral infiuences will be traced 

• • > ' 


— -— ■ ■■ 1 1 

-^^ ** J'"t" 




Our Climate, and its effect upon Disease. 

Dr. Rush tells us in one of his essays that "the 
ancient Jews used to say that a man does not fulfil his 
duties in life, who passes through it without building 
a house, planting a tree, or leaving a child behind 
him." I think my friends who were instrumental in 
placing me in my present position, must have been 
convinced of the truth of this ancient adage. It is but 
a truism to say that from the earliest civilization man 
has been negligent in the performance of duty. So 
prone are we to attend to the attainment of the present 
object, that we neglect the pursuit of many aims, not 
unworthy of persistent effort. By your kindness you 
have brought me to realize more clearly my obliga- 
tions to our profession and to this Society ; and how- 
ever remiss I may have been, allow me to promise that 
hereafter I will endeavor to atone for all past derelic- 
tions of duty, by a cheerful and hearty effort to fulfil 
every obligation imposed, and a more ardent devotion 
toward the advancement of the interests which form 
the foundation of our Society, and for the promotion 
of which it was instituted. 

The operations of nature are ever simple, and she 
attains her ends by the most familiar means. The 
deeper we penetrate her mysteries, the more clearly it 
appears that the most complicated phenomena in the 
visible world, are due to a few forces. The force that 


makes the apple fall to the ground, causes the diflFer- 
ent planets to revolve in their orbits. 

The agencies which have produced the successive 
changes in the earth's crust during past ages, are the 
ordinary agencies which we see around us every day. 
It has been supposed that volcanic and other subter- 
raneous eruptions, earthquakes and subsidence of the 
land, were the agencies which effected these changes. 
But it is now generally believed, that the valleys were 
not the product of violent dislocations, nor the hills of 
sudden upheavals, but were actually carved out of 
the solid rock, silently and gently, by heat and cold, 
frost and snow, rains and rivers, ordinary and familiar 
agencies. It will be observed that these are the ordin- 
ary meteorological and climatic agencies, and that 
these constitute climate. The various peculiarities 
or modifications of climate result from a preponder- 
ance of one or more of these agencies over the rest. 
When heat, for example, predominates, we have a hot 
or tropical climate ; when cold and frost predominate, 
we have a rigorous or arctic climate ; with moisture in 
excess, we have a damp and rainy climate, &c. '' But 
these climatic agencies are not only the factors which 
carved out the rocky face of the globe into hill and 
dale, and spread over the whole the mantle of soil ; 
but by these are determined the character of the flora 
and fauna that exist on the soil. These are determined 
mainly by the character of the climate, and not by the 
nature of the soil and conformation of the ground. It 
is from difference of climate that tropical life differs so 
much from arctic, and both these from the life of the 
temperate regions." It is climate that causes the 
orange and the vine to blossom and the olive to flour- 
ish in the South, but denies them to the North ; that 

ESSAY. 57 

enables the forest tree to grow on the plain, but not on 
the mountain-top. 

These phenomena belong not to the present age 
alone, for the geologist finds in his investigations that 
both polar and temperate regions have witnessed, since 
climates began, changes of climate and of life in won- 
derful succession, and in periods of immense duration. 
The causes which have wrought these changes have 
been investigated by the most eminent scientists of our 
time. Maury , in our own country, and Humboldt, Sir 
John Herschel, Thompson and Carpenter in Europe, 
have investigated the subject in many of its aspects. 
But to Mr. CroU, the difficult problem is given to 
solve, which he does, by attributing not only great 
secular changes of climate, but the distribution of 
temperature upon the earth's surface, at the present 
time, to causes which alter the volume, intensity and 
direction of the trade winds and other prevailing 
winds of ihe globe. In maintaining his views, he 
criticises the theories of Maury and of Carpenter, 
each of whom attributes marine circulation to differ- 
ence of specific gravity of the water, rather than to the 
winds ; the question at issue being not the amount 
of heat received from the earth' s surface, but the means 
by which it is distributed. 

Dr. Franklin, who by his truly great simplicity of 
mind, was in such intimate relations with nature, and 
therefore understood her so intuitively that he found 
a ready solution for many of her apparent mysteries, 
suggested that the gulf-stream had its origin in the 
trade-winds. Mr. Croll renews these views, and finds 
in the great wind-currents and chiefly in the trade- 
winds a cause adequate to the result. We cannot 
follow into details his exhaustive inquiries. But he 


finds the winds and ocean currents to coincide all over 
the globe. The waters move with the general set of 
the trade- winds, the direction of the one being a relia- 
ble exponent of the movement of the others ; and it is 
therefore obvious, that any influence which changes 
the direction of the winds, will also q,ffect that of the 
currents. Causes, therefore, which alter the force and 
directions of the trades are adequate to change the 
climates of the globe ; and, in the opinion of Mr. CroU, 
these causes are found in variations in the earth's path 
around the sun, combined with the precession of the 
equinoxes. It is not claimed, however^ that these 
changes are the direct result of the increased distance 
from the earth to the sun, but are the result of physi- 
cal agents thus brought into operation. As the 
distribution of heat is the controlling condition of all 
climates, and the basis of climatological distinction of 
every sort, the present arrangement of sea and land 
is the best that could be devised for the accomplish- 
ment of this end. We have in the Northern Hemi- 
sphere two immense oceans, the Atlantic and Pacific, 
extending from the equator to near the pole, and 
between these lie the two Continents — the Eastern and 
the Western. Owing to the spherical form of the earth, 
far too much heat is received at the equator, and too 
little at the poles, to make this portion of the earth' s 
surface a suitable habitation for man. The functions 
of the waters of these two oceans is to carry this 
superabundant heat to the temperate and polar regions. 
Aerial currents could not do this, as the greater part 
of the heat conveyed by them is dissipated into space. 
The functions of these aerial currents is to distribute 
heat thus conveyed over the land, and by this two-fold 
arrangement depends the thermal condition of. the 

ESSAY, 69 

That there have been investigations made, through 
private as well as governmental agencies, which go to 
prove that there is a connection between the meteorol- 
ogy of the sun and earth, is well known — but as yet 
we are ignorant of its exact nature. That there exists 
a meteorological ^period connected with the sun' s rota- 
tion, and that the convection currents of the earth 
appear to be connected somehow with the state of the 
sun's surface, as regards spots, and that the cyclones 
of the Indian ocean are most frequent when there are 
most sun spots, are theories lately presented ; and that 
the rain-fall, at least of the tropics, is greatest in years 
of maximum solar disturbance, and that there is a 
cycle of terrestial temperature, having apparent refer- 
ence to the condition of the sun, is deduced from 
recent .observations. The disturbances of the magnet- 
ism of the earth, are most violent during years of 
maximum sun spots, and that there is likewise a 
reference in magnetic phenomena to the period of the 
sun's rotation about his axis ; and that the moon has 
an action upon the earth's magnetism, that is not al- 
together of a tidal nature, but depends in part at least 
upon the relative position of the sun and moon, we 
have strong grounds for believing. 

Prom the diflferent observations made, it is philo- 
sophical to suppose three distinct effects upon our 
globe are produced by the sun. — 1st. A magnetic and 
meteorogical effect, depending somehow upon his ro- 
tation. 2d. A cyclonic effect, depending upon the 
disturbed state of his surface ; and 3d. The well known 
light and heat effect. 

We must admit that our knowledge in regard to 
these influences of the sun upon the earth is imperfect 
and speculative. But with the attention given to them, 


and with the improved means of investigation em- 
ployed, we can hope at least, that ere long, for hy- 
pothesis, we may have scientific deduction ; and that 
in discoveries to be made through them, we may be 
able to explain many of the phenomena which connect 
our luminary with the earth, and which may make 
plain to us the many enigmas we meet with in explain- 
ing atmospherical and terrestial influences, in their 
effects upon disease.* 

Most of the surface of the eastern portion of the 
United States is but little elevated above the sea, and 
is quite uniform in character. In its natural state it is 
well wooded, and all cultivable, with equally distribu-. 
ted rains, and therefore little in regard to climate 
depends directly upon the surface character. All the 
highlands belong to the Appalachian sj'^stem, or the 
several ridges of a broad belt, which are included 
under the general name of the AUeghanies. These 
elevations are not high enough, or are the ranges suffi- 
ciently continuous, where high peaks are found, to 
cause contrasts of climate on their opposite slopes. 
The higher portion of these ranges, which lie at an 

* An interefiting investigation of the phenomena connected with the atmosphere 
of the sun, as shown by the spectrum, has been lately published by Mr. Langley, 
of the Alleghany Observatory. Observations by different astronomers prove 
that the surface of our lua^iinary is less bright at the edges than in the centre, 
and this fact has been taken as proof tha1» its atmosphere is an absorbing one. 
Mr. L. states that this atmosphere is a thin stratum, which cuts off one-half of 
the heat which otherwise would reach us, and any diminution or increase in the 
absorption would affect us to a very great degree. For example, an increase of 
twenty-five percent, only, would lower the mean surface temperature of our globe 
by one hundred degrees Fahrenheit. The existence of the present order of things 
on the earth's surface would therefore seem to depend upon the steadiness of the 
sun's atmosphere. To what extent these fluctuations of temperature may have 
contributed to the Glacial Epoch already past, and what changes similar move- 
ments may be preparing for us, in some remote future, are questions worthy the 
consideration of the scientist. 

ESSAY. 61 

elevation of from 1,200 to 1,500 feet above the sea, and 
one or two small areas, which reach an elevation of 
3,000 feet, have probably more rains than the plains 
lying between them. But as the climate of these areas 
is modified only by a diminution of temperature of 
about one degrtje for 300 feet of altitude, and by a 
moderate increase of humidity, neither of these ope- 
rate in a degree so great as to entitle these mountains 
to the important place as climatological agencies which 
the mountain ranges in Europe and on the Pacific 
coast invariably hold. 

This uniformity of climate is embraced in a district 
which includes all of the continent east of the 100th 
meridian, excepting the points of local infiuence at the 
coast and near the great lakes, and is its most distin- 
guishing feature ; associated with it, is the changes of 
temperature and the oscillations of every sort which 
strike over the district, as changes over any plane 

These movements and disturbances generally move 
across the country from west to east, as though they 
were the incident of the belt of westerly winds prevail- 
ing over most of the area. 

Prof. CoflSin has deduced from a mass of observations, 
that such a belt of westerly winds prevails, and all the 
considerable clouds and storms so move, even when 
appearances indicate a reverse movement. The visible 
clouds may be driving from the northeast, southwest, 
or south, yet these are subordinate clouds ; the inci- 
dent of a saturated atmosphere and of higher clouds 
from the west. Franklin long since noticed this char- 
acteristic of our northeast storms — ^that in approaching 
us they travel against the prevailing winds. 

In the Temperate Zone, or in that portion of it occu- 


pied by the Middle Atlantic States, we are so situated, 
both geographically and topographocally, as to suffer 
but little from violent fluctuations in the amount of 
rain-fall, as compared with some other sections of the 
globe. It is roughly estimated by competent physical 
geographers, that the amount of water annually taken 
up into the air by evaporation of the surface of the 
land and sea, and which is annually precipitated by 
rain fall, is equal in amount* to a depth of sixty inches 
spread over the entire surface of the globe. This is 
the annual average for the whole earth, but where it 
falls it is not spread evenly as to quantity or as to the 
seasons. At Philadelphia, the annual average, as 
computed from records since 1825, kept at the Penn- 
sylvania Hospital, it is very near 44^ inches. This is 
the annual average for the last fifty years. In thirty 
of these years the amount was something between 40 
and 50 inches ; in the remaining years, either below 40 
or above 50 inches. The extremes were in 1825, when 
it was 29.6 as the minimum, and in 1867, the maximum 
year, when it was 61.2 inches, more than one-fourth of 
this last mentioned amount, fell in the single month 
of August of that year. 

The amount of rain-fall is distributed vnth apparent 
evenness throughout all the months of the year. The 
average for the month of February for fifty years, is 
the smallest of the year, being a very small fraction 
over three inches (3.014), while the month of August, 
for the same period, gives us the highest average, 
being slightly over four inches and six tenths (4.6); all 
the other ^months of the year show averages between 
these two. 

The great storms of our coast begin with the latter 
part of August, and their annual record shows a 

ESSAY. 63 

marked increase in their force and destructiveness as 
the summer departs. 

The old notion of equinoxial storms has been nearly- 
abandoned by modem students of the weather ; yet 
the fact »that storms cluster somewhat nearly about 
this period of the year, can scarcely be denied. To say 
that the tropical cyclones start in two belts, surround- 
ing the earth at an equal distance from the equator, 
which they never cross ; that the trade- winds, on their 
edges start the eddies which develope into revolving 
storms, and that these clyclones in their forward 
movement are chiefly influenced by the earth' s revolu- 
tion, may be true, without affecting the question 
whether the frequency of great storms at this period 
of the year is not in some measure related to the 
changes of the seasons, or in other words, to the posi- 
tion of the earth in its orbit. In the work of the 
signal service, we have only arrived at the early stages 
of its capacity. It is a great triumph to be able to 
predict the weather for a few hours, or perhaps days, 
at a given station. But when a suflicient number of 
generalizations have been attained, when we know 
better how and why and where storms originate, when 
a far greater number of observations has determined 
the period of the year in which each of these is to be 
anticipated, we will have arrived at a much clearer and 
full understanding of the movements of the atmos- 
phere, and a much more trustworthy science concern- 
ing it. 

Prof. Loomis, in an address before the American 
Academy of Science, has given us some new- hints as 
to the origin of our cold weather. The centre of the 
area of low temperature he finds nearly coincides with 
the centre of area of high barometer. This coinci- 


dence, he thinks, cannot be accidental ; and in a series 
of comparisons he finds that in a larger majority of 
instances, if there is a low barometer at a given point, 
a high barometer is fonnd at a locality to the south 
east, at a distance of about 1,200 miles on this conti- 
nent ; observations in Europe give the same result as 
to coincidence and direction, but the distance is about 
1,700 miles. In both continents the high barometer is 
also associated with low temperature. Thus when 
there is an area of low barometer in Alaska, there is an 
area of high barometer accompanied by cold, about 
the middle of the United States ; when there is a low 
barometer in Iceland, there are records of high barom- 
eter and cold at Paris and Vienna. In general there 
is a flow of air to the central position of an area of 
barometer, and it seems necessary to assume that the 
air thus concentrated must rise and flow out above. 

But it is shown that with an area of high barometer, 
there is a steady flow of air outward, and therefore 
that air must be descending from above within that 
area, and must be continuously supplied, as the out- 
ward flow is not accompanied by a falling barometer. 
It therefore seems probable that if within an area of 
low barometer the air is ascending, and simultaneously 
within an area of high barometer it is descending ; 
the air which goes up in the one, comes down in the 
other. But there is a law of compensation always at 
work, which may interfere with our assumption that 
this theory may account for our cold spells. 

The capacity of air for heat depends upon its dens- 
ity. If carried to a height the air expands, and pound 
for pound of air, there is the same amount of heat in 
it, in all directions. As we ascend, with rarity of 
air, we flnd increase of chill, until if we could be 

ESSAY. 66 

carried alive into celestial space above the limits of the 
atmosphere, we might experience a temperature near 
400 degrees below zero. 

This^theory was accepted by Prof. Henry as partly 
explanatory of areas of cold.* 

As to the question of permanence of climate, a large 
mass of historical and statistical matter might be pre- 
sented ; but the evidence is, that there has been no 
sensible change in the climate of Europe, within the 
historic period, and none in the climate of America 
since its settlement. La Place has shown that the 
mean temperature of the mass of the earth cannot have 
changed in any appreciable measure, within the 
entire period embraced by astronomical calculations, 
and that none can occur while the planetary move- 
ments remain what they now are. Climate belongs to 
the physics of the earth's mass as distinctly as do the 
tides, with the exception of the exterior agency of the 
sun's heat ; and if we determine that to be constant, 
all that remains may be treated according to the rules 
applicable in every other department of physics. The 
surface of the earth and its geological structure, 
have at some remote interval undergone great changes, 
but there are none now in progress which are suffi- 
ciently important to influence the climate in any de- 

According to the theory of Mr. CroU, changes of 
climate must have arisen from general and not from 
anv local cause or accidental combination of causes, 
and his conclusions only impress our minds with the 

rof. Loomis, in tracing storms across the Atlantic, from America to Europe, 
(Test to East, finds thej have a tendency to bend northwards, and that 
vernge velocity on the Atlantic Ocean is nineteen miles an hour, but over 
iierican Continent the rate is twenty-six miles an hour. 


immensity of the time required in some of the most 
obvious of nature's operations. His computations 
extend backward three millions and forward one mil- 
lion of years. 240,000 years have elapsed siiice the 
period of the greatest eccentricity of the earth's orbit 
occurred to which the last Glacial Epoch is referred, 
and it closed about 80,000 years ago. 

The eccentricity of the earth's orbit is diminishing 
at the present time, and in a little less than 24,000 
years it will be as nearly circular as it ever can be, 
and no cycles of extreme heat or cold will occur for 
the next 150,000 yearsw 

Humboldt makes the following reference to the 
United States, in his views of nature : ' ' The state- 
ments so frequently advanced, though unsupported by 
observations, that since the first European settlements 
in New England, Pennsylvania and Virginia, the 
destruction of forests on both sides of the AUegha- 
nies has rendered the climate more equable, making 
the winters milder and the summers cooler, are now 
generally discredited." And Dr. Noah Webster, after 
the most extensive observations, comes to the conclu- 
sion " that the hypothesis of a moderation of climate, 
appears to be unsupported." From the earliest obser- 
vations in this country, commencing in 1788, with 
regard to the annual mean temperature and rain-fall, 
and in compilations of the records made by Prof. 
Henry, we tin^ no material change ; we must, there- 
fore, conclude that there has been none worth consid- 
ering. Although the greater constants, the mean 
temperature and mean quantity of rain -fall remains 
the same, there is a local humidity, which may be 
.dissipated by the draining of lands or removing of 
forests and building of railroads ; and it is in these that 

' ESSAY. 67 

man's agency in influencing climate must be recog- 

New Jersey occupies a geographical position between 
the 39th and 42d parallels of North latitude, and as it 
forms a part of the great eastern slope of the North 
American Continent, it has extreme climatic features 
common to the North Atlantic States and the Missis- 
sippi valley, modified, however, to a considerable 
extent by its proximity to the ocean. Compared with 
some of the larger States, its extent is limited and its 
surface configuration is so slightly varied from that of 
a great plain, excepting the highlands in the north and 
western portions, that there is a remarkable uniform- 
ity in all the general features of its climate, and the 
variation is scarcely sufficient to admit any accurate 
division of the State into climatological provinces, or 
areas, having distinctive characters as regards their 
mean temperature, distribution of heat according to 
the seasons, amount and periods of rain-fall, &c. 

The gradation in the mean temperature for the year 
in going from the north to the south, amounts to one 
and six-tenths degrees (1.6°) of latitude which corres- 
ponds with the mean varieties of the Atlantic coast, 
and is equivalent to five degrees (8°) between the 
extreme northern and southern points of the State. 

The greater altitude of the northern part of the 
State lowers the mean annual temperature of those 
parts two (2°) or three (3°) degrees. The general uni- 
foimity is further disturbed by local causes, as eleva- 
tion above the sea- level, proximity of mountains or of 
thft ocean ; but we are as yet unable to define the 
limits of these disturbing agents. Taken as a whole, 
however, this disturbance from these local causes is 
scarcely appreciable, so that from its position there is 


a blending of the continental and oceanic influences, 
making it more equable than that of the interior States, 
yet not so uniform as more insular districts, or the 
western slopes of the continent which are more expos- 
ed to these softening influences of the ocean. The 
mean annual temperature of the southern end of the 
State is between fifty-three (53°) and fifty-four (54°) 
degrees, and that of the northern end forty eight (48°) 
to fifty (50°) degrees. The isthormal lines of these 
means ' show that the average temperature of New 
Jersey is higher than in the corresponding latitude of 
the Middle and Western States, as they include the 
northern parts of Virginia, Kentucky, Missouri and 
the southern part of Pennsylvania, Ohio, Indiana and 
Illinois. The mean temperature for the summer 
months of that portion of the State south of Philadel- 
phia, is seventy-three (73°) to seventy-four (74°) 
degrees ; that of the northern counties varies between 
seventy (70°) and seventy-two (72°) degrees. The 
mean of (70°) runs through Pittsburgh, Cleveland, 
Chicago and St. Paul, while that of (74°) crosses the 
Western States at Cincinnati, Springfield and Rock 
Island, For the winter months, the mean temperature 
of the northern portion of the State ranges between 
twenty-eight (28°) and thirty (30®) degrees, and that 
that of the southern between thirty-two (32°) and 
thirty-four (34°). The isothermal of thirty (30°) 
crosses the south-eastern part of Pennsylvania and 
through the central or south central portions of Ohio, 
Indiana, Illinois to central Kansas, running most of 
the distance south of the 40th parallel of North 
latitude. The winter mean of thirty-two (32"^) to 
thirty-four (34°) also tends slightly south of west in 
crossing Maryland, Virginia, and so on near the line 
of the Ohio River to St Louis. 

ESSAY. 69 

The modifying influences of the ocean raises the 
mean temperature of the winter and lowers that of the 
summer ; so that the isothermal lines for the year run 
westward nearly parallel to the corresponding lines of 
latitude. Those of the warm months curve north- 
wards after crossing the Appalachian ridges ; and 
those' of the winter are slightly deflected towards the 
south. The curvature of these summer and winter 
isothermals going westward, shows also the greater 
range between the mean temperature of the warm and 
cold seasons, indicating a more unequal distribution 
of heat throughout the year. A series of observations 
has shown the average range in places near the sea is 
less than it is further inland, and also going north- 
ward it js greater than at more southern localities, 
features characteristic of the whole eastern slope of 
the continent. 

The longer ranges accompany the greater extremes ; 
the greatest mean range is either in the winter or 
spring months, and the least mean fluctuation during 
summer. But neither the mean temperature nor the 
mean range exhibit such marked difference between 
different points of observation, as do the extremes. 

The greatest range, at a point representing the north- 
ern portion of the Kit ta tinny Valley, is one hundred 
and three (103°) degrees. The April minimum tem- 
perature of the northern point of observation generally 
fall seven and six tenths (7.6°) below that of Green- 
wich, and in October this difference averages seven 
degrees (7°), being almost equivalent to a month in 
the progress of the spring, and also the same length of 
time in the lateness of the autumn. 

The annual mean quantity of precipitated moisture is 
quite uniform throughout the State ; not however to 


the same extent as the temperature, since the varia- 
tions in the fall of rain and snow are more irregular, 
and the areas of distribution are often very much 
circumscribed, and local causes are more potent. 
From observations at eleven stations, extending 
through an aggregate period of 151 years, the average 
amount per annum lor the State is 43.84 inches or a 
little over three and a half (3^) feet. The annual 
mean at Goshen, taken as the representative station of 
the Kittatinny Valleys is 34 inches, showing the great- 
est variation from the State average. The average 
quantity at Greenwich is given as (41.4) inches, and 
that of Paterson is (66.8) inches, and of Newark 
(45.68) inches : showing Paterson to be under some 
local influence which makes its rain-fall considerably 
greater than that of Newark. 

Prom observations taken at stations selected as rep- 
resenting all the important surface features and 
districts of the State, the variation runs from 34 to 
66.8 inches, or if we exclude Paterson and substitute 
West Point, as typical of the highlands, the range is 
from 34 to 46.5 inches. The distribution of this 
amount is not uniform for the seasons at eleven places 
whose observations are longest. May is shown to be 
the wettest in eight (8) and August in the remaining 
three (3). January and October are the driest months. 
The summer season has generally an excess of two 
inches over that of winter, and the spring exceeds 
that of the autumn. These observations show a 
remarkable uniformity among these stations in the 
distribution according to the seasons, as well as the 
uniform ratio that prevails between the amounts of the 
several seasons, and that the mean monthly fall varies 
little from one-twelfth of that of the year. From all 

ESSAY. 71 

the records obtainable, there are no proofs that the 
climate of New Jersey has materially changed since the 
settlement of the State in the seventeenth century.* 

The diflSculty in determining to what extent climate 
alone may affect any given disease, lies in knowing 
precisely how far other causes may operate in produc- 
ing it. That there are diseases, each having its 
specific cause, and the latter only producing each its 
particular disease, is rational and almost demonstra- 
ble. We are acquainted with many of the conditions 
under which the causes are developed, and we know 
many of the laws of their operation, but we have yet 
to learn their nature. The discovery of one special 
cause might lead to a similar knowledge of other 

If we could attain a knowledge of their nature, we 
would be directed, almost by intuition, to the discovery 
of the means of destroying them, or to the neutraliz- 
ing of their morbific operation, and thus the most 
destructive of the acute diseases would be prevented 
or arrested in their progress. It has been claimed 
that these special causes are either animal or vegetable 
organisms, and on this assumption is based the " germ 
theory of disease." To those of us who heard the late 
Prof. J- K. Mitchell lecture twenty-five years ago, the 
theory of the cryptogamic origin of many diseases 
comes up, with all the cogent evidence and argument, 
as presented by that distinguished medical teacher. 

We need many more facts to determine the influence 
of the atmosphere in the production of disease. Why 
do warm, equable climates engender disease of the 

* As an act of courtesy, as well as of justice, we take pleasure in acknowled^f- 
ing our Indebtedness to Prof. Geo. H. Cook, for assistance in furnishing valuable 
materfal in regard to the Mean Annual Temperature and Bunfall of our State. 


liver and alimentary canaU Why are cold and 
especially variable climates attended with diseases of 
respiratory system and with rheumatism ? Why has 
the influence of the east wind passed into a proverb ? 

There is one of the constituents of the air most 
remarkable in its nature and properties, and is present 
in small quantities. The researches of many chemists 
have placed the supposition beyond doubt, that it is a 
condensed form of oxygen with greatly exalted chem- 
ical activity ; its energetic nature or oxydizing power 
surpassing that of oxygen, as much as the activity of 
the latter excels that of air. According to the conclu- 
sions of M. Houzeau, country air contains an 
odorous, oxidizing substance, with power of bleaching 
blue litmus, without previously reddening it, of 
destroying bad smells, and of bluing iodized red 

That this substance is ozone, that the amount of 
ozone in the air at different times and places is vari- 
able, but this is at most one volume of ozone in 700, 000 
of air, it is found much more frequently in country 
than in town ; it is greatest as to quantity in spring, 
less in summer, diminishes in in autumn, and is least in 
winter. It is most frequently detected on rainy days, 
and during great atmospheric disturbances. Atmos- 
pheric electricity is apparently the great generator of 
ozone. Prof. Pfaff, (Braithwait's Retrospect, Vol. 40) 
from observations made at Plauer, in Saxony, at an 
elevation of 1,050 feet above the level of the sea, con- 
cludes with respect to the influence of ozone, that its 
presence in the atmosphere acts mischievously on 
diseases of the respiratory organs : that it exerts little 
or no influence on epidemic diseases, provided these 
are not complicated with catarrhal affections. An 

ESSAY. 73 

excess of ozone in the air, whatever may be the direc- 
tion of the wind, favors the development of inflamma- 
tory affections and especially tonsillitis. 

Other diseases beside these mentioned do not seem 
to be influenced by the presence of ozone. 

The geographical position of our State is snch as to 
present within her limits the same geological, meteoro- 
logical and climatic conditions as is experienced by 
other neighboring States, although these are modified 
by peculiar oceanic and other local influences, and it 
remains for us to determine what effect these may have 
upon disease. In the language of M. Boudin, " Man 
is not born, does not live, does not suffer, does not 
die in the same manner in all points of the earth. 
Birth, life, disease and death, all change with the 
climate and soil, all are modified by race and nation- 

The best source from which we should be able to 
derive information regarding the prevailing diseases of 
our State, their usual course, duration and treatment, 
is in the reports of our Standing Committee for the 
several years in which they have been published. But 
these are made up from data too general in their 
character, to arrive at a minute and reliable knowl- 
edge concerning th^m. This defect is not from any 
want of capacity on the part of the Committee, or of 
the Reporters in the several districts, but from the 
nature of the material furnished them by members of 
the profession. A common complaint of our Report- 
ers is that their appeals for contributions are unheeded, 
thus the object to be obtained by the plan is defeated. 
*' We can only arrive at a correct knowledge of the 
amount and distribution of health and disease within 
a given territory, through the agency of many medi- 


cal observers. Loose or general statements in regard 
to the occurrence or prevalence of maladies in certain 
districts and localities, are not suflScient at the present 
day to meet the requirements of medical science. In 
figures only is there exactness, and consequently not 
until medical practitioners shall report every case of 
sickness, will it be possible to affirm to what extent a 
country is healthy or otherwise. In no case known to 
us, have statistical enquiries yielded results thus full 
and complete." 

As we view New Jersey, we find she is among those 
portions of the earth in which occur almost every 
variety of disease. ''There are, however, disorders 
which scarcely or never appear within her boundaries. 
Thus the plague is unknown this side of the Atlantic. 
The Dengue has never or scarcely reached so far 
north. The Yellow Fever has appeard, but confined 
within very narrow limits. Certain other disorders 
are scarcely or never met with as original or endemic 
affections, as Cretinism, Elephantiasis and Lepra. 
The more prevalent forms of endemic disease are of 
a febrile character, occurring mostly in districts or 
localities, the geological formation of which are favor- 
able to the production of malaria. These maladies 
have types common to the periqdical fevers of other 
States of the Union. The contagious exanthemata 
find here a genial climate, and are developed from 
time to time in all their severity ; and these with 
other disorders prevail over the State, irrespective of 
latitude or topographical peculiarities." 

Although the climate of our State may not be so 
uniform as that of California and the western slopes 
of the continent, it possesses elements which render it 
superior in many respects to the climate of many 

ESSAY. 75 

places situated near its centre. The air which we are 
now enjoying, is a fair example of that which she can 
aflford to those who are so fortunate as to be exposed 
to its influence. 

Possessing a coast line of more than one hundred 
miles, she presents facilities and advantages, not only 
to the pleasure-seeker, but to the invalid, not to be 
excelled in any part of the world. The air is noted 
for its healthfulness, as is proven by the multitudes 
resorting every year to enjoy it, and is to be accounted 
for by its comparative dryness and its equability of 
temperature. The different points along her coast, 
which are every year receiving more attention, all 
possess advantages, with which our profession are 
becoming familiar, and of which they are disposed to 
take advantage in looking after the welfare of their 

The class of diseases which are greatly benefited 
by its atmosphere is a large one, and incudes all cases 
of rheumatic fever, arthritis, chronic bronchitis, laryn- 
gitis, incipient tuberculosis and scrofula. We need 
not confine ourselves entirely to the coast-line, but 
find this salubrity of climate extending some miles 
inland, ''to the regions of the Pines," which for 
generations has been the resort of the valetudinarian 
and those suffering from diseases of the lungs, kid- 
neys or digestive organs. 

As there are patients with whom every physician 
meets, who are not benefited by the sea air, for which 
peculiarity I will not attempt to account ; the hilly 
portion of the State presents just the atmosphere for 
their improvement and restoration to health. 

In many of these, malaria is unknown, and with an 
atmosphere comparatively free from humidity, and 


with a mecllmn range of temperature, the invalid in- 
hales vigor and strength with every inspiration ; and 
many retluoed to the lowest point of vitality, are 
restored to liealth, and at the same time, enjoy all 
the ueoessariea and luxuries required for the invalid. 


BT B. B. BATES! AN, M. D. 

Meittal Pathology akd Criminal Law. 

Man is the master-piece of creative power. What 
artist ever conceived a piece of machinery so wise in 
its adaptation to a grand purpose, so elegant in its 
workmanship, and so perfect in its finish, as the hu- 
man body ? And this body is the temple of the mind, 
the shrine of the intellect, the home of the soul. We 
may not imagine, with hope of satisfactory answer, 
how or when the embryo becomes possessed of mental 
faculties, for such questions baffle the researches of 
science, and put to the blush the wisdom of philoso- 
phers. The little babe born into the world in the 
early morning, and sleeping so sweetly upon the arms 
of its nurse, has a something in its composition that 
links it with divinity, and if perchance, it should die 
before the setting of the sun, its parents would give it 
the rite of burial, and speak of it as immortal. 
Whence comes this immortality ? At what hour in utero 
does the child take on the principles of an endless ex- 
istence? Where is mind located in the lobes of the 
cerebrum ? What anatomist, in his dissections, has 
•disclosed the secret chamber of the heart, or with his 
microscope revealed the germs of soul-life ? In refer- 
ence to these and a hundred kindred questions, psy 
chology is able to indulge in nothing better than idle 


And the modus operandi of the diseases affecting the 
cerebral mass — those diseases that modify brain-struct- 
ure, and disorder the action of the intellect — ^is but 
little better understood than the existence of mind 
itself. But is medicine less a science because its 
votaries are compelled sometimes to grope their way 
through subterranean passages and unexplored laby- 
rinths in their search for Truth ? Is astronomy less a 
science because there are stars that have never come 
within the range of the telescope — constellations and 
systems far beyond the lens of the astronomer, whose 
orbits have never been reckoned, and whose distances 
have never been computed ? Is religion less a science 
because we cannot understand the mind of the 
Infinite, or by searching find out God, and demon- 
strate to our own satisfaction and that of others, the 
problem of the Trinity ? Are we not rather in a world 
of unexplained wonders, and surrouftded by an infini- 
tude of mysteries ? And is not the human body in 
health, and the human body in sickness, the most in- 
explicable of them all ? 

Several prominent hypotheses have been advanced 
to explain the existence of non-congenital insanity. The 
psychological , Semitic and intermediate theories have 
each and all had their admirers and advocates. But the 
theory adopted by European and American alienists 
at the present day, *' assumes the brain to be the 
instrument of the mind, the physical instrument of 
mental action, and that a morbid physical change 
must occur in the brain, or in its investing membrane, 
as a precedent fact and cause of insanity." Perhaps 
the peculiarities of our American life, the overtaxed 
state of our nervous energies, the little time one finds 
for recuperation, the blind subserviency of our people 

ESSAT. 79 

to the imperious demands of fashion, the pernicious 
habits that the young men and women of the nine- 
teenth century are contracting in the billiard saloon 
and ball-room ; perhaps these, and a hundred other 
things, are tending to the development of those mor- 
bid physical changes in the brain that result in the 
derangement of the intellectual faculties. The fact is 
as patent as it is lamentable, that diseases of this char- 
acter are largely on the increase in our country. The 
census reports more than 30,000 cases of insanity in 
our lunatic asylums ; the majority of which are the 
beneficiaries of the State. Many other thousands, 
blessed with wealth, are watched and cared for by 
loving hands in the quiet of their own homes ; while 
a third class, whose actions are sometimes marked by 
the impulses of an ill-balanced and disordered intel- 
lect, are under no restraint whatever, enjoy freedom 
in every thing, until an act, perhaps of a criminal 
nature, discloses the existence of the mental derange- 
ment, and brings the offender before a court of 

The victims of moral insanity are numbered, I 
believe, by the tens of thousands. We meet them in 
Wall street and in the Exchange ; we encounter them 
in railroad cars and on ship board ; we attend them 
professionally when sick, dine at their tables when 
well, and maintain with them for years friendly rela- 
tions of the most intimate character. Says Dr. Geo. 
B. Hord, "there are numerous individuals mingling 
in society, and participating in the ordinary avocations 
of other men, whose sentiments and conduct are so 
peculiar as to attract general attention ; but who can 
reason so well upon all subjects within their capacity, 
and whose intellect is often so clear, and in many 


instances even strong, that no one questions their san- 
ity. They are simply said to be singular or eccentric. 
Now the fact is, that such individuals are not unfre- 
quently as much under the control of their morbid feel- 
ings, act as irrationally in obedience to these feelings, 
and are morally as little responsible for their acts, as , 
others who carry out in their conduct some false con- 
clusions of the intellect." And then, inexplicable as 
it is, we know that persons in the perfect possession 
of their mental faculties are sometimes seized with the 
propensity to commit an insane act without any appre- 
ciable motive or object whatever. Sometimes they 
rush headlong to the act in obedience to the impulse, 
which takes them, as it were, by surprise, so that they 
have apparently no time for resistance. In other 
instances the impulse is less immediate and powerful, 
and the patient is able to hold out against it until the 
morbid condition of brain, in which it originates, 
ceases spontaneously, or under the influence of reme- 
dies. The tendency is most striking when it takes, as 
it not unfrequently does, a violent or illegal direction. 
There is reason to believe that an insane impulse has 
oftentimes impelled individuals to take their own life, 
and that of others. Have we not had several lament- 
able instances of this kind in our country during the 
past year? Was it not an impulse of this nature that 
lead Ralston, the banker-prince of California, to com- 
mit suicide? And was it not a fit of momentary 
insanity that drove Albert W. Markley, a name 
known to many of you, and honored as well as 
known, to cast his body in the waters of the Dela- 

History furnishes many instances of moral insanity 
among those who have adorned the highest pages of 

ESSAY. 81 

literature. Poor Cowper was the victim of a hypo- 
condria that embittered his life from early youth to 
old age, made him the most miserable of men, and 
sent him to his grave with the darkness of delusion 
still veiling his spirit. The poetry of Cowper, that has 
stirred the heart of unnumbered thousands, and melt- 
ed to tears with its sweet tenderness, was much of it writ- 
ten when he was dejected in spirit, and continually 
haunted by the spectres of a monomaniac. The world 
was to him the translation of Homer, and yet the world 
but little knows the darkness and gloom that en- 
shrouded this ' ' unhappy chief of genius, " as he 
prosecuted for weary years his task. Cowper was 

And the question of Lord Byron's hypochondria 
will not be disputed by those familiar with his 
writings. Its various protean forms are there set forth 
in language which affectation could not forge, nor 
fiction mimic. "I must write," says this brilliant 
poet, ''to empty my mind, or I shall go mad." It 
was a paroxysm of melancholy that gave to the world 
one of the most humorous of his productions, and 
produced in a single night a poem which has immor- 
talized his name. With what exquisite pathos, in 
Childe Harold, does he refer to those circumstances 
which had such a depressing influence upon his life 
and character. 

" I have thought 
Too loDg and darkly, till my brain became 

In its own eddy boiling and overwrought, 
A whirling gulf of phantasy and fame ; 

And thus untaught in youth my heart to tame, 
My springs of life were poisoned." 

Again, the student of history familiar with the char- 
acter of Dr. James Johnson, well remembers those 



exhibitions of mental depression which rendered him 
so teiTibly sad beyond expression. Johnson' s melan- 
choly manifested itself at the early age of twenty, 
and increased in intensity as he advanced in years. 
The leading symptom of his hypochondria was the 
apprehension of death, and every day appeared to 
aggravate his terrors of the grave. Like Metastasio, 
he would not permit the word to be pronounqed in his 
presence. His disease, which embittered his life from 
early manhood, cast a shadow of deepest gloom over 
his dying hours. 

History furnishes many instances of this character. 
But why multiply examples? The mental delusions 
of Cowper, and Byron, and Johnson, and Pope, and 
Bums, and many others equally well known to the 
student of literature, have been given to the world 
with minutest detail by their biographers. These all 
were men conspicuous above their fellows ; and the 
public to-day, and the public a hundred years from 
to-day, will read with avidity every circumstance of 
their sad history that gave color to their thoughts, 
and stimulus to their life-work. But how many 
thousands of cases of hypochondria there are, scarcely 
kijown beyond their own roof- tree, who live and die 
the victims of a monomaniac delusion. I have known 
them in the pulpit, at the bar, in the ranks of our own 
profession, and in the walks of private life. 

So numerous are the cases of hypochondria that it 
becomes an exceedingly difficult question for even a 
forensic physician to decide between real and simulat- 
ed insanity. If a crime is committed, the cry of the 
populace is, '' the perpetrator is insane ; no man in his 
senses would be guilty of such a cold-blooded deed." 
Artful lawyers avail themselves of this existing 

ESSAY. 83 

opinion, or so present the cause of their client as to 
create the belief, and thus the jury acquits the crimi- 
nal upon the plea of insanity, and sets him at liberty, 
with his hands red, perhaps, with the blood of his 
brother. "My client is insane," says the lawyer, 
and insanity is not incompatible with the prosecu- 
tion of a profession, nor does it incapacitate one for 
the discharge of the ordinary duties of life. Cowper 
was insane, and yet wrote the sweetest of poetry ; the 
bard of Scotia was the victim of hypochondria, and 
yet stirred the heart with his tender lyrics ; Napoleon 
was subject to epilepsy, and yet led a vast army and 
conquered his enemies ; Mohammed sometimes fell 
into terrible convulsions, and yet drew unnumbered 
thousands after him in the establishment of his new 
religion. "Now, you may have known this man," con- 
tinues the lawyer, "from boyhood, and may never 
have suspected him insane ; he may have been success- 
ful in his business, upright in his dealings, pure in his 
morals, and blameless in his life ; but he must have 
bfeen the victim of an emotional insanity, or he would 
never have been arraigned before a court of justice 
upon the charge of murder." Now is it any wonder 
that twelve men, who in ninety-nine cases out of a 
hundred, know nothing about physiology or psychol- 
ogy, or the relation of mind to body, or body to mind, 
should be mystified by such pleadings, and should be 
ready to swear, when they are released from the jury 
box, that all the world has gone mad, and they alone 
have escaped to tell it. 

The facility with which this plea of insanity may be 
used, and the influence which it always exerts upon the 
minds of a jury, when skillfully employed by a shrewd 
barrister, has defeated the ends of justice in thousands 


of cases, and turned upon the community unpunished 
men, who ought to have hung as high as Haman. A 
man in a fit of anger sends a ball through the head of 
his fellow, and when brought to trial, the jury are 
told that the criminal was insane. Medical experts 
are examined to substantiate the assertion, and the 
jury, unable to distinguish between anger and insanity, 
give the prisoner the benefit of their doubtg, and set 
him at liberty. 

Wharton reports Briand as saying, that from the 
height of passion to madness is but one step, but it is 
precisely the step which impresses upon the act commit- 
ted a distinct character. It is important, then, to know 
exactly the precise characteristics of the passions and 
of insanity. But here science fails, for it must be ad- 
mitted that we are unable to point out the place where 
passion ends, or where madness commences. M. 
Orfila draws the following distinction between a man 
acting under the impulse of the passions and one urged 
on by insanity. The mind is always greatly troubled 
when it is agitated by anger, tormented by an unfortu- 
nate love, bewildered by jealously, overcome by 
despair, humbled by teiTor or corrupted by an 
unconquerable desire for vengeance. Then, as it is 
commonly said, a man is no longer master of himself, 
his reason is affected, his ideas are in disorder, he is 
like a mad man. But in all these cases, a man does 
not lose his knowledge of the real relation of things ; 
he may exaggerate his misfortune, but this misfortune 
is real, and if it causes him to commit a criminal 
act, this act is perfectly well-motived. Insanity is 
more or less independent of the cause that produced 
it ; it exists of itself ; the passions cease with their 
cause, jealously disappears with the object that pro- 

ESSAY. 83 

voked it, anger lasts bnt a few moments in the absence 
of one, who, by a grievous injury gave it birth. 
Violent passions cloud the judgment, but they do not 
produce those illusions which are observable in 
insanity. Thjey excite for a moment sentiments of 
cruelty, but they do not produce that deep 'moral 
perversion which influences the madman to sacrifice, 
without motive, the being he most cherishes. 

Was it not a fit of anger that sacrificed the life of 
Dr. Parkman, at the hands of Prof. Webster, in 1849 ? 
Did any one ever venture to intimate that the repeated 
demands of Dr. Parkman for the payment of the 
claims due him, had driven the Prof, insane ; that the 
latter, goaded by an insane impulse, had invited the 
former to his laboratory in order that he might take his 
life, and that the arm which struck the fatal blow 
acted in obedience to the impulses of a disordered 
intellect ? Was it not understood then, and is it not 
believed now, that Prof. Webster killed Dr. Parker in 
a fit of momentary anger ? And did not the city of 
Boston, and all the country approve, even when they 
mingled tears of sympathy with their approval, of the 
verdict that demanded the life of the Professor in 
atonement for the life of his victim ? 

Now the thoughts already expressed in the essay, 
and those which are to follow, have had their origin in 
the recent decision of a criminal case by the District 
Court of the County of Cumberland. 

On the 19th of March, 1875, Chas. K. Landis enter- 
ed the office of Uri Carruth, the editor and publisher of 
the Vineland Independent^ and learning, upon inquiry, 
that Carruth was temporarily absent, awaited his return. 
While thus waiting, he employed the time in reading. 
Immediately upon the entrance of Carruth, Landis 


deliberately arose and . presented a revolver. The 
editor fled through a door into the composing room, 
closely pursued by his antagonist, who fired one shot, 
the ball lodging in the base of the skull. The wound- 
ed man fell to the floor and was supposed to be dead. 
In reply to the employees of the oflice and others, Mr. 
Landis said, " I have killed him ; I was obliged to do 
it ; I killed him in the cause of God and humanity ; I 
am sorry for it ; I hope he will not die." Friends 
hurried to the scene and found Carruth still living ; a 
bed was extemporized in the composing-room, and he 
was given into the hands of experienced surgeons. In 
the meantime, Landis was incarcerated in the county 
jail. Weeks passed on, and Carruth, with the ball 
still in his brain, began a gradual convalescence. In 
the month of June he was so far recovered that he 
took, by the consent of his attending physician, a trip 
into New York State, and remained there until the 
first of August. Soon after his return to Vineland, 
certain complications of an unfavorable character pre- 
sented themselves ; he grew rapidly weaker, and very 
unexpectedly died upon the 23d of October, 1875. Lan- 
dis who had been at liberty upon bail, was remanded to 
the county jail, and at the January term of Court, 
1876, was tried for the wilful and deliberate murder of 
Uri Carruth. 

It was known that a feud had existed between these 
parties for many years ; that Carruth had prostituted 
the columns of his '^ paper" to the vile purpose of a 
slanderous and personal attack upon the name and 
reputation of Landis ; that this course 
had been persisted in week after 
after month, and that the imm' 
shooting was an article writt*^ 

ESSAY. 87 

reflecting upon the character of Mrs. Landis, which 
article came to the notice of her husband upon the 
morning in question. 

When tlie case was opened by the defence, the com- 
munity was amazed beyond expression by the plea of 
insanity, strongly put in behalf of the prisoner. The 
defence did indeed review the matter of mal- treatment, 
and tried to show that certain abscesses in the region 
of the wound w6re caused by unskillful and officious 
probing, upon the 12th of May, twenty-two days after 
the reception of the injury ; and that the deceased, 
having steadily refused to allow them opened, died in 
consequence therefrom. But it was quite evident that 
the question of mal-practice had but little weight with 
the jury. The verdict turned upon the plea of in- 

A better understanding of this case may require a 
brief statement as to the character and work of the 
defendant. Chas. K. Landis is a lawyer hy profes- 
sion ; early in life he became interested in colonization, 
^nd after a successful effort at Hammonton, N. J., he 
entered more largely into the scheme, by purchasing 
in 1861, 30,000 acres of woodland in the township of 
Landis, county of Cumberland. By judicious adver- 
tising he soon called around him settlers f roro. oil parts 
of the country, and the beautiful town ot Wii^, 
numbering 6,000 inhabitants, after a Isips^ ol ftlteeu 
years, rewarded the energy and ent>e>x^Yvsft oi 
founder. ^ 

During these years, Landis did an itn-T^^^^"^^^' ^"^^Yaxvg 
of business in real estate ; was interest^^^ "^"^^^ tov?^ '> 
that promised to promote the welfar^ -v cVcvz*^"^^ 

siv vsratched the highest interests ^^ . ^ot ot9^^^' 
; , / to V^** ' - " an enviable T^pxx^^^ *^^ 


He Spoke much in public, wrote much for the press, 
travelled much abroad, mingled with men everywhere, 
and yet no one ever broached a suspicion of his insanity. 
Its first intimation came fnom his counsel daring the 
farcical trial ; and so skillfully was it handled, that the 
twelve intelligent men who constituted the jury, after 
an absence of forty-eight hours from the court-room, 
returned with a verdict of not guiUy, upon the plea of 
insanity. Two days thei-eafter, an Examination was 
made by order of Judge Reed, into the mental condi- 
tion of Mr. Landis, with a view, as I suppose, to his 
incarceration in a lunatic asylum, but having been 
pronounced in open court perfectly sane, he was set at 
liberty, and continues the prosecution of his business 
as before, blasted in reputation, it may be, but un- 
harmed in body. He steps aside but for a moment to 
avenge himself of the wrongs inflicted by his adver- 
sary, imbues his hand in the blood of his persecutor, 
silences forever the pen of criticism and the tongue of 
slander that had so often annoyed him, and when 
brought to trial for the highest crime known to the 
court, by the maneuvering of his distinguished 
counsel, escapes the gallows, escapes the walls of a 
prison for life, or any limited number of years, escapes 
even the imposition of a fine to cover the cost of pro- 
secution, escapes everything of a punitory nature, and 
all upon the plea of insanity 1 Well may the goddess 
of justice in the State of New Jersey veil her fair 
face in shame, and cl 

Things are coming 
that it is almost impc 
nal. The rich take 
redress real or imagic 


er, and then bribe jnstice with gold, and blind a half- 
starved jnry with volnminous testimony, proving the 
deed to have been committed in a fit of emotional, 
momentary, or invisible insanity. " I shonld not be 
afraid to go before any jnry," said Landis, months 
before the shooting of Carrnth, "with that man's 
blood npon my skirts." Is it not time for the intelli- 
gence of onr conntry, in the interests of religion, 
morality and. good government, seriously to consider 
where we are drifting in the matter of penal punish- 

During the past six years there have been 281 mur- 
ders in the city of New York, and 274 of the mur- 
derers have escaped the gallows. The penalties of the 
law inflicted only in seven cases ! Will human law be 
regarded, or human life respected, under such a las 
administration of jnstice ? The shrewd lawyers of the 
metropolis, by their strategic dodging, "plea of 
insanity," " stay of proceedings," and applications 
to the Court of Pardons, are every day thwarting the 
ends of justice, and every decade turning upon the 
community a battalion of homicides to repeat their 
merciless acts. 

Is it not time that the criminal laws of our country 
were so modified as to adapt them more thoroughly to 
the requirements of psychology ? Have we not come 
to that period in the national life, when the public 
good demands the abolition of the death penalty — 




passions of men? The experiment of abolishing 
capital punishment is not altogether new in our coun- 
try. Five States have tried it. Michigan led the van 
in 1846, fand daring the first thirteen years after the 
repeal of the death penaly, there were thirty convic- 
tions for murder. During the next fourteen years, 
with an increase of 50 per cent, in lier populution, 
there were only twenty-six convictions, Tliese figures 
furnish an argument in favor of a change in our penal 
legislation, and such a modification of criminal law as 
shall insure certainty of punishment. Wisconsin, 
Iowa, Rhode Island and Maine, have each and all fol- 
lowed the example of Michigan, and are so well' 
satisfied with the repeal of the law and the substitu- 
tion of imprisonment for the gallows as to refuse the 
restoration of the statute. 

I am aware of the arguments used against the aboli- 
tion of capital punishment. I know that it has been 
ui^ed that imprisonments generally end in pardons, 
and that thus, in the majority of cases, criminals escape 
the just punishment of their criminalty. But could not 
the laws be so fixed as to prevent the possibility of such 
an occurreuce, and make the punishment as certain aa 
the crime ? Impressed with the importance of a rad- 
ical change in our penal legislation, I venture to make 
the following suggestions, viz : 

1. Imprison for life every person convicted of 

2. Make the disposition of the case a final one, 
putting it forever beyond the reach and influence of the 
Court of Pa- y- " ~ 

3. Forbid 

4. Abolis 

ESSAY. 91 

and let the evidence be submitted to a court of 

6. Interdict impassioned appeals of lawyers to the 
sympathy of the court, and let the facts as they fall 
from the lips of ■witnesses, under oath, decide the case 
in hand. 

6. Make imprisonment for life to mean, hard labor 
and compulsory edncation. 

Now in addition to these or similar changes in our 
penal laws regulating tlie trial and punishment of 
criminals, many of these questions which have hereto- 
fore been considered from the stand-point of ethics 
•only, must be referred to medical science. And this 
brings me in conclusion only briefly to notice the rela- 
tions which educated medical men sustained to the 
general question under consideration, and for which 
oar profession ought to be held responsible by an 
intelligent public. 

I. It is the duty of medical science very sedulously 
to inquire into these morbid states of body and mind 
that so often instigate acts of a criminal nature. The 
records of our penitentiaries and prisons prove beyond 
question that the perpetrators of crime in almost every 
instance, are men not possessed of " mens sana in cor- 
pore sano," but rather those whose bodies have been 
enfeebled by disease, or a long continued course of 
dissipation, which in the end provokes a sympathizing 
feeling on the part of the brain, and a partial derange- 
ment of the mental functions. Now can medical 
science do anything to prevent or in anywise mitigate 


Society of New Jersey has given considerable atten- 
tion to the subject of Hygiene, and very wisely, for 
the subject is one not only of vital importance, per se, 
but it has a direct bearing upon, and sustains an inti- 
mate relat'"" *" *^° ™«„™i «^^=h^t, ^t „^™« 
Remove fr 
those caus 
insure to tl 
you guarai 
Take away 
consigns in 
tiary in the 
vice, who, 
and frenziei 
peration to 
a shadow i 
be the dut 
partially to 
their undiv 
cal science 
the causes, 
n. Bdut 
exalted po 
How often 
educated m 
direction t( 
fancy the o 
the conserv 
lead the vai 
ures. And 
influence, 1 


the bench of Judges, and in the chair of State, clothed 
with Gubernatorial honors. N*ow is it not within the 
province of our profession, in each and all of these 
capacities, to inaugurate a spirit of reform? What 
class in the community should be more Argus-eyed 
than educated physicians ? Our profession does not 
reach its ultimatum in the administration of hypo- 
dermic injections, the prescription of pellets and 
powders, the amputation of a limb, or the removal of 
a tumor. The bravest men that ever shouldered a 
musket were those who fought with Cromwell; but 
when the battle was over, and the uniform was ex- 
changed for the garb of the civilian, Cromwell's 
invincible soldiers were found to be the most trust- 
worthy of citizens. We have no right to divorce those 
obligations which as physicians we owe to a suffering 
humanity, from those duties which as citizens we owe 
to the State. If criminal acts are being multiplied in 
our country, it is manifestly the dutj'' of our profes- 
sion, not only to institute an inquiry into their history, 
but to consider the provisions of law for the punish- 
ment of criminals, and the probability of the execu- 
tion of such laws in the light of recent statistics, and 
urge upon the attention of the people, and their 
representatives in legislative bodies, such reforms as 
in our judgment will conduce to the highest social, 
moral and religious well-being of the nation. 

III. And finally. We are living in times when 
educated medical men must guard against bending 
their influence in thwarting the ends of justice, and 
shielding from punishment those known to be guilty 
of penal offences. Esau sold his birthright for a mess 
of pottage. For thirty pieces of silver Judas betrayed 
his Master. Honor and honesty are not concentrated 

in the i 
ago, wl 
of Surj 
lowing ] 
devil V 
'here s 
the gloi 
there is 
sams a] 
poses, s 
grow ai 
of consi 
years aj 
time as 
esty of 
at snch 
at snch 
much Dj 
is ming 

ESSAY. 95 

Men whom the spoils of office caDnot buy ; 

Men who possess opinions and a will ; 

Men who have honor ; Men who will not lie ; 

Men who can stand before a demagogue 

And damn his treacherous flatteries without winking ; 

Tall men, sun-browned, who live above the fog 

In public duty and in private thinking ; 

For, while the rabble, with their thumb-worn creeds. 

Their large professions and their little deeds — 

Mingle in selfish strife, lo 1 Freedom weeps, 

Wrong rules the land, and waiting Justice sleeps." 


Mr. Presiden 
essayist, I have 
before I have fi 
tion will becom 

Some three m 
Dr. Pierson, hi 
title of my- fortJ 
to name oflFspri 
How could I tt 
itself in some al 
Bible ; or, worse 

I must, theref 
the title of "M* 
track, and brin 
subject. I can 
people thought 
young man was 
a successful fan 
too dumb for a 
yon could put h 
cal College and 
most people rec( 
physician, the s 
moral and menti 
as an educated, 

ESSAY. 97 

common sense, (that rarest of all kinds of sense), and 
erected upon this basis, a careful medical training. 

Among the moral qualifications integrity, purity, 
sympathy for suffering, and charity are deemed essen- 
tial, but no one seems to think that bravery and 
heroism are at all requisite ; I shall, therefore, assume 
the position that every practitioner of medicine is 
either brave or ignorant. 

The young medical student who sits quietly poring 
over his books, or w^ho picks up the medical journals 
of our day, or who as he advances to college and sits 
from day to day listening to the flowery lectures of the 
course, or in the dissecting room studies the perfect 
and wonderful mechanism of the human form, is apt 
to leave his alma mater with the idea that the grim 
tyrant, death, will loose his fangs on his intended 
victim and disappear at his bidding ; but when he 
reaches the bedside of his first critical case, and tries 
his vaunted remedies, and fails, his courage and his 
conceit are very likely to ooze out at his finger ends. 
I well recollect my own experience in that line. I re- 
ceived my first call with considerable pride, as it was 
to a leading lady of the neighborhood, but the nearer 
I approached the house the greater I appreciated the 
responsibility I was about to assume. On reaching 
her bedside I asked her attendants all the questions I 
could possibly think of, (for the patient was appa- 
rently insensible), and the more answers I received the 
more I became confused, until I was ready to swear 
that she was full of '' itis's" all the way through, from 
Iritis to Metritis, and was racked by all the pains from 
tic-douleureux to gout in the toe, and finally lit upon 
the happy idea of sending six miles through dark- 
ness, mud and mire, and dragging my invalid father 



from his midnight slumbers to aid my diagnosis. He 
came, he saw, he conquered all my difficulties, all my 
conceit, and my dying patient's hy steroidal troubles 
with a stout dose of valerian. *^Oh what a fall was 
there, my countrymen !" I was weaned. 

So long as differences exist in the constitutional 
characteristics of patients, it will be impossible for 
authors and teachers to lay down rules or plans of 
treatment that dare be taken as an infallible guide ; 
and although thorough medical education, clinical 
training, and a good library of medical authorities are 
indispensable to the practitioner, he must possess 
bravery enough to cut himself loose from their thral- 
dom and pursue such a course as his own judgment 
may dictate, even though adverse to the*recognized 
practice, with a full knowledge that if he does so, and 
tlie case terminate unfavorably, he will be open to 
criticism and censure. 

Irregular or quack practitioners who are ignorant 
of the mechanism of the human body, the laws of 
health, the symptoms and ravages of disease, and the 
effects of remedies, may be extremely bold, for they 
know no danger, and therefore feel no kind of respon- 
sibility. To them it is a blessing that the grave covers 
their blunders. 

The heroism that makes men march in solid column 
up to the cannon's mouth while belching forth its 
deadly showers of grape and canister, or mount the 
ladder, in the midst of lurid, scorching flames and suf- 
focating smoke, or plunge into the rushing, seething 
torrent, to save a life endangered, is of one kind ; but 
the heroism of an intelligent physician who stands by 
the bedside of his patient surrounded by anxious rela- 
tives and friends that depend on him for aid, and scan 

ESSAY. 99 

every expression of his countenance that they may 
anticipate his opinions, and calmly and coolly decides 
his course, even though liis brain be racked with 
anxious thought, not only as to what he shall do, but 
when he shall do it, is of a very different type. 

Let us imagine a scene, and I presume I will have 
no difBculty in bringing it before jDur minds, although 
I am no artist, for I presume no physician present has 
escaped one or more such cases. You are called from 
your bed some stormy, dismal night, to the bedside of 

Mrs. B , and, remembering her condition, you 

grasp your forceps and such other appliances as are at 
hand, and when you reach her, find her laboring 
under convulsions — puerperal convulsions. 1 dare not 
attempt to describe the scene — memory alone can paint 
it in all its hideous forms. You are alone, perhaps 
miles away from medical assistance ; the agonized 
friends are looking to you alone for aid. You must 
think for yourself, act, advisedly, and accept the con- 
sequences, not in the result of that case only, but in 
your reputation thenceforth, for if your case result 
unfavorably, you have none to verify your diagnosis 
or support your practice. Your patient, perhaps, lies 
insensible, the convulsions occurring at short inter- 
vals, teeth clenched and deglutition impossible ; pulse 
quick and bounding ; labor, perhaps, scarcely com- 
menced ; pains slow, weak, or entirely deficient ; the 
OS undilated, and yet you feel that the treatment must 
be early delivery or death. In the twinkling of an 
eye you review your authorities. Shall you bleed and 
reduce the life current ? that must be your stay and 
support should your patient reach the stage of con- 
valescence. Shall you use anaesthetics ? they arc, per- 
haps, miles away. Shall you use forceps? the os is 


not sufficit 
you but qi 
BO much 1 
relax the ( 
patient's li 
low ; your 
hand— the 
and the in 
Dare you t. 
Meigs or I 
a certain e 
your duty 
trusted hei 
courage en 

But agai 
decide up 
you can bi 
what you 
with a pr 
you, you i 
child perh. 
life of the 
piece by p 
has been s 
every facu 
reeking fr< 
your patie 
the heroisi 
is of a k 

You ma; 
suffering i 

ESSAY. 101 

unseated at once, will hurl its victim into eternity. 
The stridulous breathing, the quick inflammatory 
pulse, invite you to the battle. How will you fight ? 
Will you meekly order your demulcent drinks, your 
warm foot baths, with a few drops of hive syrup or 
ipecac, or will you bravely grapple with death, and, 
knowing that he is certain to conquer on the one hand, 
take the little sufferer under your own control, and 
rather risk his death with your full doses of veratrum 
and emetics, than fold your hands and see him perish 
by strangulation ? 

The gentleman who places himself, his wife, or his 
child in the hands of a physician, has a right to expect 
that physician to be, not only qualified for his duty, 
but brave enough to assume any responsibility that 
the exigencies of the case may require. He who 
takes no step, except at the instigation of his medi- 
cal authorities, and prescribes after their recommenda- 
tions only, soon becomes a mere routinist, and in those 
acute cases where death stares the patient squarely in 
the face, too often finds that while he is weaving 
theories, his patient has slipped from his fingers, for 
want of prompt assistance. But it is folly for me to 
waste any more valuable time or arguments to prove a 
position which all are willing to admit, and as I am 
determined my effort (as essayist) shall be meritorious 
in some respect, I will let that merit be — its hrenity. 


• • ■ 

The Standing Committee has been furnished with 
reports from all the District Societies, maintaining 
their relations with the State Society except Ocean 
county, which, having just been organized, we sup- 
pose, has not placed itself in complete working 
condition. The committee received a letter in April, 
from the last secretary of the Somerset District 
Society, stating that it had held no meeting for 
two years, and that it may be considered as dis- 
organized. The reports received are mostly full, and 
evidence care in their preparation. Complaints are 
expressed in some of them, that the members of the 
local societies do not respond to their personal duties 
in rendering a record of their medical experience. 
We may hope that those who are faithful to duty, 
will provoke their associates to good works ; that 
this is growing to be the case, is manifest by the 
experience of the last few years. 

The general health of Bergeis' County has been 
as good as the preceding two or three years. In 
Hackensack there has seemed to be an entire absence 
of all epidemic influences, or more correctly, an 
entire absence of all manifestations of such influences 
in the prevalent diseases of the year. There have 
been less malarial fevers than usual, but the more 
common serious results of malarial poison have been 


manifest in the different forms of neuralgia, which 
yield only to large doses of quinine. In regard to 
malaria, there were a great number of cases of a 
peculiar character, both pernicious and marked fevers, 
some of them being typho-malarial, many of them 
not to be designated by any distinct type, because of 
the absence of distinctly marked pyrexia or apy- 
rexia, running their course without any, or with only 
slightly developed febrile manifestation, with little 
more than general malaria. Dr. Hopper, who has no- 
ticed these cases, remarks that he does not share in the 
opinions of that class of medical observers who 
always associate malaria with swamps and other low 
lands, and who find in them the almost exclusive and 
prime factors of its production, a-ud believes that its 
origin is in and around our dwellings, the products to 
be classed among preventable diseases. They are the 
direct result in many cases, of the inhalation during 
the hours of sleep, of an atmosphere poisoned by 
mephitic gases from out-door water-closests, in prox- 
imity to the open windows of sleeping apartments. 
In Park Ridge there was a continued decrease of 
intermittent fevers ; early in the winter diphtheria 
and scarlet fever appeared in different localities, and 
were more or less prevalent during the winter and 
spring ; many of the cases were severe and compli- 
cated. In Ridge wood and vicinity the prevalence 
of dysentery was noteworthy, approaching an epi- 
demic. Diphtheria was rife, and its fatality in some 
places fearful. The same disease has prevailed 
extensively in the lower part of the county, particu- 
larly in Carlstadt and vicinity. In Englewood there 
have been an unusual number of cases of pneumonia 
of a decided malarial type, confined chiefly to the 

u ^ 

* u • 

4 yj *» 


yonng. There was also much whooping cough. 
Influenza and other affections of the air passages, and 
rheumatism, with a few sporadic cases of diphtheria in 
a mild form. 

Burlington County in its medical history pre- 
sents nothing of particular interest. In Beverly, 
measles and whooping cough were the only epidemics. 
During the fall and winter, bilious remittent and. 
intermittent fevers prevailed to some extent, with a few- 
cases of typhoid of a low grade. During the spring 
a great many cases of catarrh occurred, affecting the 
nose, throat, frontal and maxillary sinuses, and extend- 
ing in many cases to the eustachian tubes and ears, 
attended with a severe spasmodic cough, and in many 
instances in complete aphonia. In Tuckerton the 
year has been one of universal health along the shore, 
but at Bass River a fearful scourge of diphtheria has 
existed during the greater part of the winter and 
spring. Dr. Reeves, the practitioner there, has 
treated about one hundred and lifty cases in a popu- 
lation of eight hundred. He estimates that one- 
quarter of the population of the infected district was 
affected in a greater or less degree. Its mortality 
reached about 10 per cent. The complaint was con- 
fined to an area of about six miles square. The 
evidences of contagion were, in the estimation of Dr. 
Reeves, quite manifest. In Mt. Holly during July, 
August and September, in a limited locality of the 
town and on the border of the low meadows, at times 
overflowed by high tides, there were a number of cases 
of typhoid fever, made peculiar by its rapid co 
speedy emaciation and enteric symptoms^' 
The majority of the cases occurred ^ 
four years of age ; most of the case 


In Cape May Cotjntt the only epidemic was influ- 
enza. Sporadic cases of scarlet fever, pertussie, 
measles and diphtheria appeared, and of a tractable 

lu Camden County, throughout the whole year, 
scarlatina and diphtheria have prevailed, bxit not to 
any great extent. During the autumn some cases put 
on a malignant type in the city of Camden, where 
seventy deaths occurred. Some cases of whooping 
cough and enteric fever presented themselves during 
the whole of the year. About the middle of Febru- 
ary, variola appeared in Camden City in a locality 
where typhoid fever was then prevailing, opposite to 
which a culvert emptied its noxious contents on a 
large marsh ; nearly all the cases of typhoid fever 
which the reporter met with were found here, and all 
the cases of variola were also in the same locality. 
The close proximity of the place wherein these two 
diseases were found, suggests very forcibly the close 
relation between putrefaction, fermentation and 

Cumberland County has experienced a general 
prevalence of health. The only diseases mentioned 
by the reporter as worthy of record, is membranous 
sore throat, which was epidemic, followed by a 
genuine epidemic of influenza. In Millville, erysipelas 


scarlatina, pertussis 
in the city of Newi 
Montclair daring th 
many cases. The e 
extensive, but did m 
disease distinct from 
jority of cases, a 
Pneumonia has beer 
and the western pa 
the last two months, 
among the guests of 
about the Ist of Aug 
The cases of diphtlK 
been caused, in aln 
sanitary conditions. 

In Gloucester C 
vailed extensively, 
peculiar ; quite fata 
Una has also beer 
reporter says, is th 
three years ago. T 
very few deaths ; m 
there are very many 
riolence of its onse 
or of the nephritic ( 
neighborhood of I 
endemic, for a time, 
months, in the plac' 
of the air-passages, 
which it may be said 
sual is the number 
pronounced their syi 
them to constitute 


tinct epidemic tendency. ■ Few have escaped. Malaiaej 
unaccountable depression of strength and spirits, 
rigors, aching over the whole body, particularly in 

the calves of one or both legs (oftener in the left), 
soreness of the fleah, and the aggravation of existing 
predisposed disorders. These are the leading charac- 
teristics of what the laifcy term " this cold that's going 

Hudson County has been marked by an unusual 
amount of sickness, and has suffered by the prevalence 
of diplitheria to an unusnal degree throughout the 
year — no section of the county has escaped. Elevated 
sites, surrounded apparently by the most favorable 
conditions, have been affected alike with the tenement 
house on the low grounds where the conditions to 
invite disease are present. Its extent is indicated by 
the fact that diphtheria and croup (most of the latter 
of which was diphtheria) was the accredited cause of 
death in 17! per cent, of all the deaths during the year 
in the county. Pneumonia, mostly of an asthenic 
type, was prevalent during the winter. Scarlet fever, 
mostly in a mild form, was unusually prevalent. 
Rubeola, of a very severe type in many instances, has 
been very common during the spring. Its marked 
feature was the unusual length of the prodromic stage. 
The various sequelae of the disease were more frequent 
by observation than usual. Bronchial and intestinal 


In Mercer 
Trenton in the i 
ing fatal in so 
four. Its viru 
whole, the nun 
qaite limited. 
fest, as its dii 
traced to one o 
been wide-spres 
its manifestatii 
. eliminating, req 
been more fre( 
character, with 
nicated to the ( 
wearing a gam: 
child sick with 
and seventeen 
tution were brc 
pertussis has b 
in form, but ve 

Diphtheria. ] 
there have bee 
from the dises 
tality there tc 
parative rate 
about the sam< 
spring ; cholei 
beola, roseola, 
spring, and fe 
their usual frei 
tent fever, run 
red— 50 of the 


house, and nearly all fatal. In Dayton, miasmatic 
fevers of a mild type were very frequent. 

In Monmouth County the general health has been 
good with one or two exceptions. Long Branch and 
its vicinity has been scourged by diphtheria of a most 
malignant type, attended by great mortality, leaving 
few families who do not monrn the loss of some little 
one, and, in some cases, it has counted all among its 
victims. In other parts of the county the disease has 
been sporadic and of a mild form. 

Morris County is reported as experiencing an 
increase of disease. In addition to the ordinary con- 
tagious diseases of childhood, diphtheria was endemic 
in Rockaway, Boonton and Middle Valley. In the 
former place there were probably 150 cases, 12 per 
cent, proving fatal. In Middle Valley the percentage 
of mortality seems to have been materially affected by 
the methods of treatment, allusion to which will be 
made hereafter. In Boonton the mortality was about 
20 per cent. Scarlet fever, generally of a mild form, 
has been quite generally observed. Roseola very 
general, but requiring little professional attention. 
Measles has been largely epidemic over the county, 
except a district within a circle with a radius of four 
miles, thickly populated, and having within its limits 
15 practicing physicians. An interesting fact in con- 
nection with this immunity from the general epidemic 
is, that just here, in '71 and '72, an epidemic of 
Rubeola Nigra of a malignant type occurred, with 
fatality in very many cases. For the past year not a 
single case is known to have appeared in this district. 
Gastric disease was much observed during the past 
» I u ner andanumn, and dysentery endemic in some 


placss. Cholera morbus is noted by the reporter as 
a common affection among the iron miners, sometimes 
proving fatal. A large proportion of the cases occur 
among foreigners of the laboring class. The reporter 
feels assured that change of climate is the predispos- 
ing, while the change of diet is the exciting cause. 

In Passaic County our reports relate chiefly to 
Patersoh, which has been visited by Scarlatina and 
Diphtheria Of the latter there have been many cases 
and a large per centage of deaths. Scarlatina appear- 
ed with its usual variety of type, some cases being 
very malignant and others so mild as to require no 
medical treatment These diseases, with influenza, 
are all which are noticed by the reporter. 

Warben County hag had an amount of sickness 
above the average of past years. The prominent dis- 
eases prevalent were dysentery, typhoid fever, diph- 
theria, measles and pnenmonia. The dysentery was 
not of a fatal character — two or three deaths occurred 
from the accession of cerebro- spinal symptoms, com- 
plicating the intestinal affection. Diphtheria was very 
prevalent "f^ n^irfrir,! nr,^ ;» ■n'-«=iii..o.fn„ -M-^nc^i^D i,«= 
been wid< 
tinning to 

[The re] 
to this rei 

A reviei 
with a sin 
ease throi; 
forms in 
being rati 


peared in leaa amount and with less serioua manifesta- 
tions than in fonner years. Fevers, Remittent and 
Intermittent, have not claimed the attention of pliysi- 
cians to any degree. Diphtheria has been the only 
prevalent affection, and it has been the scourge of the 
year. This general condition of the diseases of the 
year, haa been associated with a meteorology some- 
what unnsual ; the past snmmer being generally cool, 
and distinguished by numerous and severe rainfalls, 
and the winter open, with little rain or snow, the 
spring opening about twenty days earlier than usual. - 

In Therapeutics the reports afford many valuable 
suggestions, a few of which the Committee notice. 

In the use of Quinine a growing disposition is mani- 
fest to employ it in very large doses. Wlien cerebral 
excitement attends its use, Dr. Clendenin, of Bergen, 
employs a saturated watery solution of camphor as 
a vehicle which he says counteracts its effects upon 
the brain. Salicylic acid has not met the expectations 
of many physicians, while others have met with good 
results, used externally and as agargle in throat affec- 
tions. The Chlorine treatment in sore throats of 
Scarlet Fever and Diphtheria has impressed many 
practitioners with its great value. Large doses of Tr. 
Ferr. Chlo. Bt. Potass. Chlor. administered every 10 
or 15 minutes, "as a rule acts like magic." So says 
the reporter from Bergen. 

In the Erysipelas reported in Cumberland County, 


its inefficiency ia due to tlie limited qnantity used, 
rather than to its lack of remedial value. 

Dr. H. W. Coleman, of Trenton, emphasizes the nee 
of MonseVs Solu. of Iron in diphtheritic sore throat, 
and says that it promises better success than any other 
remedy yet offered to the profession. This opinion is 
based upon an esperience of eight years. His senti- 
ments as to the mode of cure, and his method of apply- 
ing the remedy, are given in full in bis paper upon the 
subject herewith submitted. 

Dr. Farrow, of Morris County, employed in an 
endemic of Diphtheria cold water and ice to the 
throat externally ; Carbolized Lime Water inhala- 
tions ; Chlor. of Potash when the patients could 
gargle, and in severer cases, a room Jilled with the 
vapor of water, the patient being made to breathe also 
from a pitcher containing Slacking Lime, strongly im- 
pregnated with Carbolic Acid ; internally, Tr. of Iron 
and Chlo. of Potash with Quin. and Sulphite of Soda. 
With this treatment, in twent 
five or six involving the lary 
proved fatal. With hot appl 
opposite treatment, a neighbor 
out of three of his cases ; per 
experience, Dr. J. W. Hunt, 
watched the disease both in i 
forms, and under various pla 
own and others hands, does i 
ever seen a case cured by anj 
satisfied that any treatment ad< 
disease or caused the result to 
yet his record of mortality is as 
has come under his notice. 

In Surgical Appliances, Dr. 


reports the employment of the Elastic Ligature in the 
removal of a malignant tumor between the left mam- 
mary gland and the clavicle in a lady aged 70. It 
measured in its longest diameter five inches, in its 
shorter three ; had been 4 years developing, and for 4 
months in a state of ulceration with fetid discharge 
and an occasional profuse hemorrhage. The patient 
being etherized, a slight cut was made around the base 
of the tumor to form a groove for the ligature ; a nee- 
dle armed with a strong thread was passed behind the 
tumor at the centre, by which a dotible ligature was 
drawn through ; the ends of the elastic cord were then 
tied on either side, thus strangulating the mass. The 
ligature gave but little inconvenience, and the general 
condition of the patient began to improve at once. In 
nine days the separation was so nearly complete that 
the remaining tissue was cut with the scissors, npt a 
drop of blood escaping. Cicatrization was complete 
in a month, and the patient's health is as good as that 
of most persons of her age. It is now eleven months 
since the operation. 

The Committee solicited replies from the Reporters 
upon the following subjects : *' The value of Topical 
Applications in Malignant Sore Throat," and " In 
what degree Calomel is relied upon as a Therapeutic 

In response to the first enquiry we notice the senti- 
ments of the profession as furnished by the reports. 
Dr. Hasbrouck, of Bergen, regarding the sore throats 
of Diphtheria and Scarlet Fever as the concomitants 
of a constitutional condition, has abandoned the se- 
verer applications by means of sponges, probangs and 
the solid Nit. of Silver, and now relies upon remedies 
directed to the constitutional affections. He recog- 



nizes, however, the val 
Chlorine in its combint 
and Tr. of Iron, and th( 
Acid and other remedi 
the same county, in 
finds Chlorinated or ( 
nostrils to be attendee 
Diphtheria. If, thereb, 
free from the fetid colle 
will rest better, from th 
will be less obstructed i 
into the stoniach to 
throughout the system, 

Dr. Brown, of BurliU; 
remedies are very usei 
relied upon. 

Dr. Stokes sayB, "I hi 
remedies as valuable 

Dr. Thornton has ver 

Dr. Townsend relies 
cal remedies in all fom 
gether with cold extern 

The physicians of B 
cations of value in mali 
indispensable as disinl 
ness of the parts, and a 
cent parts by the morbi 

Dr. Elwell considers ■ 
a mUd, soothing and ge 
means keep in check th 
eifect of constitutional 

Dr. Price hardly dart 
without local applicatii 


solutions of N. of Silver, and is not now convinced 
that he has found anything better. He now uses the 
solution somewhat weaker ; also Tr. of Iron combined 
with honey or syrnp. 

The Reporter for Cumberland regards them as im- 
portant, yet subordinate ; when violently applied they 
only do harm. A proper choice from the long array 
of appliances are serviceable. 

In Essex County, Dr. Pierson inclines to the opinion 
that such remedies are of value as cleansing agents 
only. Hot water and hot vapor are of the most value. 

Dr. Holden is convinced that any malignant disease 
of the air passages, not directly the result of local in- 
oculation, is to be reached by constitutional remedies, 
and that local treatment is but the adjuvant to remove 
effete and offending matter. 

Dr. Love condemns all attempts to remove the infec- 
tious element from the mucous membrane by severe 
measures, such as caustics, &c., and believes that the 
use of antiseptics and disinfecting solutions by the 
syringe or atomizer may be useful in destroying infec- 
tion and preventing general poisoning. 

The Reporter of Gloucester County says the general 
sentiment upon topical applications is, that if the 
malignancy displays itself mainly in the throat, they 
are of undoubted value ; if the malignancy is consti- 
tutional, they become of secondary importance. 

In Hudson County, Dr. Vondy finds most benefit 
from Chlor. of Potash and Tr. of Iron, and believe^ 
that their influence for good, used topically, is con- 

Dr. Burdett considers them only valuable as ad- 

Dr. Mitchell considers caustic and irritating appli- 


cations as hurtful ; has no faith in steam or ice. He 
obtains an antiseptic and anodyne effect from the use 
of a three or five per cent, solution of Carbolic Acid 
applied every hour. 

Dr. Lutkins has no confidence whatever in any local 

Dr. Morris uses none other than the Sol. of Chlor. 
of Potash combined with Tr. of Iron. 

Dr. Porman uses internal remedies so frequently as 
to make application almost continuously to the throat ; 
also Carbolic Acid and Lime Water by gargle or sprays, 
and considers them of value when the membrane is in 
a nascent condition, and of no use whatever in bad 

Without prolonging the extracts from the reports, 
those already given are suflBlcient for our conclusion 
that topical appliances in malignant sore throat, 
which, in nearly all the observations recorded, means 
Diphtheria^ are — 

1st. Not curative, except it may be in the formative 
stage of the disease. 

2d. They cannot with propriety be wholly ignored. 
They become valuable aids to successful treatment, as 
disinfecting, soothing and cleansing agents. 

3d. The irritating and more heroic applications of 
a few years since, are generally abandoned as hurtful. 

4th. The main reliance for cure must be placed 
upon remedies addressed to the morbid constitutional 

The second subject of enquiry suggested by ^^^ 
Committee is the therapeutic value of Calomel, ; 
to what degree it is at present relied upon as a remea*. 
agent. - 

When the writer of this report was a medical stu- 


dent, one of the recognized standard works on the 
practice of medicine, though at that time beginning to 
be superseded by later works, was Armstrong' s Lec- 
tures. His remarks upon agents in treatment was, 
that the Lancet was the right arm of medicine and 
Calomel the left, and the general practice of physicians 
seemed to be an admission of its truth. But tempora 
midanter et nos mutamur in illis. Calomel became 
an unpopular remedy, and has been largely superseded 
by others. Its power as a drug is universally recog- 
nized, and its abuse, in the days of its popularity, 
equally so. It seemed to the Committee that it would 
be profitable to know its present status in the arma- 
mentaria of the profession. Hence our enquiry. 

In Bergen County the reporter says that for many 
years he has ceased to rely upon the drug in inflamma- 
tions, acute or chronic, and has ceased to use it only 
in exceptional cases. In one disease he always uses 
it, that is Iritis — nothing can supply its place, whether 
the inflammation be acute or chronic, of syphilitic 
origin or not. Its effects are so uniformly prompt and 
certain that he would as soon think of treating inter- 
mittents without barks as Iritis without Calomel. This 
is the only disease in which he relies upon the drug as 
a therapeutic agent. He uses it, however, in cholera 
infantum in combination with Bismuth and other 
agents. K%2i,pv,TgaMve^ he most frequently uses it, 
and as such, in some cases, particularly in children, 
its eflTects are truly admirable. A good Calomel purge 
will at once and permanently relieve those cases occur- 
ring in children with fever, torpid bowels, a foul and 
slimy toDgue, loss of appetite and offensive breath. 

In Burlington County, Dr. Clark quotes the language 
of Dr. Headland :— **It is the prince of that class of 

118 Medical society of i^ew jersey. 

remedies, unfortunately too few, that we are capable 
of entering the system, of grappling with disease of 
the blood and coming off victorious in the struggle." 
He is accustomed to use it in all those morbid condi- 
tions requiring an efficient hepatic stimulant ; in ver- 
minous affections of children, and in cholera infantum, 
in combination with other agents, it allays obstinate 
vomiting when nothing else is effectual. 

Dr. Paterson relies upon the drug to control cynanche 

The physicians of Bordentown use it in inflamma- 
tions of the serous membranes, to prevent the forma- 
tion of lymph, and to promote absorption when it is 
formed. In inflammations of the mucous membrane, 
when adventitious membranes are, or are likely to be 
formed ; in most cases of dropsy ; in primary syphilis, 
and in abnormal secretions of the liver. . 

Dr. El well relies upon it in pneumonia, catarrhal 
fever, pleurisy, some diseases of the eye, syphilis, the 
acute stage of gonorrhoea, and in some diseases of the 
brain, spinal cord and their investing membranes. 

Dr. Townsend uses it in all cases of portal conges- 
tion or irregularity of the liver, generally combined 
with blue mass and podophyllin or aloes ; seldom 
uncombined, and does not rely upon it any further 
than its action upon the liver. 

Dr. Thornton relies upon it in some infantile cases 
as a febrifuge ; in oft repeated and minute doses in 
acute gastritis ; in erysipelas ; in dropsies, to increase 
the power of diuretics ; in some functional affections of 
the liver ; sometimes in inflammations . of the serous 
tissues, and very often in the beginning of some dis- 
eases combined with purgatives. 

Dr. Brown believes it to be a valuable remedv in 


combination, in some brain diseases and affections of 
the liver when an active purge is required, and in heart 
affections consequent upon rheumatism. 

The reporter from Cumberland remarks that we 
cannot practice without Calomel in the hepatic dis- 
orders accompanying our summer and autumnal 

In Essex County, Dr. Pierson says " there are no 
morbid conditions in which I rely upon Calomel as a 
therapeutic agent," 

Dr. Holden has not had occasion to use it or pre- 
scribe it but twice in ten years. He believes its value 
to be unquestioned, but that it is easy to succeed with 
other and less unpopular remedies. 

Dr. Love relies upon it in iritis and inflammations 
of the deeper parts of the eye ; in syphilis, primary, 
secondary and congenital ; in infantile diarrhoea, 
cholera and indigestion ; to increase biltary secre- 
tions ; to allay some forms of vomiting ; in some skin 
diseases ; and, finally, whenever he wishes to alter 
nutrition by aflecting the blood-making organs. 

Dr. Kipp uses it as a topical application in 
phlyctenular conjunctivitis ; in all forms of syphilitic 
eye affections, though he prefers inunctions. He 
places more reliance upon the merc^irials in syphilitic 
eye diseases than upon any other remedy. 

In Gloucester County, every extreme of opinion is 





the hands of ignorance. He has furnished a valuable 
paper upon this subject, which is appended to this 

In Hudson County, Dr. Lutkins believes it to be a 
medicine of great value in all acute serous inflam- 

Dr. Vondy considers it of great value in membra- 
nous croup. He also uses it as a purgative in certain 

Dr. Morris uses it as a cathartic, and in bronchial 
catarrh, combined with ipecac and chalk ; in children 
under 4 years of age, attended with much vascular 

Dr. Hunt employs it as a cathartic, and believes it 
to be one of the best remedies known to the profession. 

Dr. Craig uses it in serous inflammations, and in a 
full dose as a commencing step in the treatment of 
many complaints when the tongue is furred, with las- 
situde, headache, loss of appetite, nausea, &c. 

In Morris County, about one-third of the physicians 
use the drug as a cathartic. The only condition in 
which any rely upon it is in certain stages of syphilis, 
engorgement and torpidity of the^ liver, and topically, 
in abrasions of the cornea. A large proportion of the 
physicians of the County seldom use it for any pur- 
pose, and a few never administer it. 

In Passaic County, Dr. Rogers places a high valii'- 
upon its use in the second stage of croup, and in soiik 
cases of pneumonia. He would hardly undertake to 
treat any decided case of croup if he wei'«' ilpliarie'! 
from the use of this potent remedy. In miiiti 

his judgment is, that it forms a very ess« . nf 

the necessary treatment, and the most di. i 

all the more modem remedies in many cu 
supply its place. 


In Warren County, the reporter says Calomel seems 
very necessary in croup ; in acute vomiting or in gas- 
tric spasm, and in the acute stages of dysentery. 

A valuable paper on mercury is submitted with this 
report by Dr. Currie, of Bergen County, on the action 
of mercury, possessing much originality and scientific 
value. Some of its conclusions are as follows : — That 
it should be used only so far as to stimulate the nutri- 
tious changes of the tissues and the character of the 
constituents of the blood, and that it should be used 
as a whip and spur only, that is, occasionally and at 
intervals, and not continuously. Again : that there is 
no question as to its power over the products of inflam- 
mation, in starting the process of resolution and absorp- 
tion, when these have been arrested ; and, further, that 
no number of cases improperly treated with mercury, 
no number of constitutions shattered by its abuses, no 
number of instances where cases have been cured with- 
out it, can in any way invalidate the results of its 
effects when it has cured, where other remedies have 
failed, or lessen, in any measure, the position which 
he defends, of a judicious use of the n^edicine. 

The sentiments now quoted warrant, as the Com- 
mittee believe, the inference — 

1st. That the very general opinion of our medical 
men is, that Calomel is a valuable therapeutic agent. 

2d. That in many morbid conditions it is relied 
upon as the best. 

3d. That as a cathartic in certain cases, as an altera- 
tive in others, and as an anti-fibrinator, it is almost 

And the lesson which the discussion of the whole 
subject furnishes is, that a valuable drug should not 
be abandoned, and *^ its name cast out as evil" be- 
cause it is unpopular. 


The length of our report forbids a notice of the many 
cases of interest which are in the hands of the Com- 
mittee and which are submitted for publication. 

We note the names of fourteen physicians who, since 
our last meeting, have been called away by death : 

Dr. Orson Barnes, of Pate/son, died in July, 

Dr. Jolin Grimes, of Boonton, died September 1211, 
1876, aged 73 years. 

Dr. John G-. Schanck, of Princeton, died September 
37th, 1875, aged 25 years. 

Dr. Cbaa. F. Clark, of Camden, died October 16th, 

1875, aged 75 years. 

Dr. Chas. Dunham, of New Brunswick, died Decem- 
ber 19th, 1875, aged 45 years. 

Dr. Benj. H. Stratton, one of the Fellows of the So- 
ciety, who was at our last annual meeting, and who 
was always present at oar annual gatherings, died De- 
cember 29th, 1875, aged 71 years. 

Dr. Z. W. Scrivens died at Long Branch, February 
11th, 1876, aged 49 years. 

Dr. Thos. Page died at Tuckerton, February 18th, 

1876, aged 77 years. 

Dr. James Vanderpool, 
January 14th, 1876. 

Dr. E. W. Maines, of I 
14th, 1876, aged 45 years. 

Dr. Addison W. Wood! 
14th, 1876, aged 45 years. 

Dr. Jacob Fisler, of Gloi 

Dr. Jno. Leavitt, of Bapt 
died April 4th, 1876. 

Dr. Chas. S. Champion, 
16th, 1876, aged 34 years. 


Obituaries of the most of these are in the hands of 
the Committee, as also of Dr. Cornelison and Dr. Jobs, 
who died; the former in Jersey City, and the latter in 
Springfield, a few days before onr last meeting. 






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§» pmayiftm* 


Born Feb. 7, 1830. Died Dec. 9, 1875. 


Born June 8, 1798. Died Feb. t8, 1876. 


Born A. D., 1830. Died July 23, 1875. 


Born A. D., 1791. Died Mar. 19, 1858. 


Born A. D., 1802. Died Sept. 12, 1875. 


Bom Nov. 4, 1841. Died January 14, 1876. 


Born Feb. 6, 1804. Died Dec. 31, 1875, 





Gharlbs S. Champion, M. D., the son of William 0. Champion, 
was born December 17, 1842, near Haddonfield, New Jersey ; received 
his medical education at the XJniyersity of Pennsylvania ; graduated 
March, 1865 ; served as surgeon in the army until the close of the 
war; settled in Woodstown, N. J.; there married Miss Rachel C. 
Jones, daughter of Thomas Jones ; afterward moved to Daretown, N. 
J. Eight months since (owing to the breaking down of his health) 
gave up practice, and removed to his father's house,* Vincentown, N. 
J., where he died on the 16th of May, 1876. 

He was highly respected as a man and a physician, and died in the 
firm belief of salvation through the atonement of Jesus Christ. 



Dr. Woodhull was a native of Monmouth County, son of Dr. John 
Woodhull, and brother of Judge Woodhull. He was bom in 1831, 
graduated at Princeton in 1854, studied medicine, was PeniteQtiary 
Physician on BlackwelPs Island in 1856, and came to Newark in 1857. 
In 1861 he left a young wife and a fine practice and became Assistant 
Surgeon of the Ninth New Jersey Regiment, and afterward became 
Surgeon and Chief of Hospital at Beaufort, N. C, during Bumside's 
campaign, and subsequently with Rosecrans, and afterward with Sher- 
man during the latter part of his grand march to the sea. Since his 
return he has held various positions of honor and trust, having been 
physician of the County Jail for several years, President of the New- 


ark Medical Association, of the Essex County Medical Society, one of 
the first physicians of St. Miehaers Hospital, a member of the Board 
of Examiners for pensions, and, at the time of his death, a medical 
examiner for the Mutual Benefit Life Insurance Company. He was a 
prominent member and ruling elder of the South Park Presbyterian 
Church, and a teacher in the Sunday School, which has appointed a 
joint committee, consisting of F. Wolcott Jackson, David C. Dodd, 
Jr., and E. L. Hamilton, on the part of the Parish School, and Archi- 
bald Parkhurst, Thomas Darlington and John Y. Foster, on the part 
of the Mission School, to prepare some suitable memorial of the de- 
ceased. The teachers of the two schools attended the funeral in a 
body. In social as well as professional life he had the confidence and 
esteem of every one. Of high literary attainments, he was a lover of 
the arts, and was very skillful in his profession. In his religious life 
he was known by his daily walk and conversation, and was faithful to 
every trust. The community at large will sympathize with the be- 
reaved family and lament the loss also as a serious one to the church, 
the profession and society. He leaves a wife and four children. 



Eugene Jobs was born February 23d, 1821, at Liberty Comer, 
Somerset County, New Jersey ; was the son of the late Nicholas C. 
and Margaret C. Jobs. He began life, after a common country school 
education, by teaching for a time, and also served as an assistant to 
his father in his store at Liberty Corner. 

He studied medicine with Dr. Smith English, at Manalapan, Mon- 
mouth County, graduated from the medical department of the Uni- 
versity, of Pennsylvania, April 4th, 1844, and was licensed to practice 
in this State, at Elizabeth, by the Board of Censors of the Medical 
Society of New Jersey, for the Eastern District, September 11th, 1844. 
A copy of this license was filed with Dumont Frelinghuysen, Somerset 
County Clerk, October 11th, 1844, and with John P. Jackson, Essex 
County Clerk, July 14th, 1846. Dr. Jobs began the pursuit of his 
profession in Springfield, Union County, in the spring of 1845, where 
he continued uninterruptedly until the period of his death. He mar- 
ried October 28th, 1846, Mary L., oldest daughter of Thomas C. Allen, 


of Connecticut Farms, Union County. She died September 13th, 
18G3, leaving two sons and two daughters. He joined the Presby- 
terian Church in Springfield, in the year 1848, and remained thence- 
forth a consistent member. His life was suddenly brought to a close 
by an attack of apoplexy, May 22d, 1875, in the fifty-fifth year of his 
age. He was buried in Evergreen Cemetery, Elizabeth. 

Patient, industrious, ambitious, his incessant toil, his great expos- 
ure, his many hardships at last terminated by the utter ruin of an 
overtaxed brain. Such was the life and such the end of one who 


practiced the art of medicine for the space of a whole generation, and 
whose life might be taken as a model of the humble follower of the 
Good Physician, for surely he was continually " going about doing 
good." His practice was large, though not a very remunerative one, 
extending through several townships. His poor patients received his 
attention, as well as his wealthy ones. 

At his funeral, the large number of sincere mourners from the 
country round, spoke volumes for his worth and the public loss. In 
all the relations of life, as father, son, brother, husband, physician, 
friend, his character was the same. The thorough performance of all 
his duties, without ostentation and without complaint; his long 
experience had justly built him up a local reputation as a skillful 
physician, ready for any and all the contingencies a country doctor is 
called on to meet— rendered local only by his own unassuming mod- 
esty and retiring disposition. It will be many years before his mem- 
ory will wane in his neighborhood, or grow dim among his friends 
and brethren — and fragrant and good it is. 


BY 8, H. HUNT, M. D. 

Dr. Zebulon W. Scrivens was born in Petersburg, N. Y., Sep- 
tember Ist, 1828, and died February 11th, 187C, at Long Branch, N. 
J., from pneumonia, complicated with other diseases. His busy life 
did not permit him to identify himself with our District Medical 
Society, though he expressed his desire and willingness to do so at 
the first opportunity. Being more than nn ordinary man, and oc- 
cupying a large place in the hearts of his professional brethren, as 
well as in the community where he lived, labored and died, I have 


thought well to pay this tribute to his memory, for the love I bore 

From his early childhood he was a hard student and a literary 
aspirant, possessing a retentive mind that never grew weary in its 
pursuit after knowledge. In 1849 he graduated with honor from the 
Literary University at Madison, N. Y. He afterward read medicine 
with Dr. A. H. Hull, of Berlin, and graduated at the Albany Medical 
College in 1852. He practiced his profession one year at Petersburg, 
one year at Eagle Mills, N. Y., when in 1854 he succeeded Dr. Jacob 
Yanderveer, at Long Branch, in a laborious and increasing practice, 
extending over a section of country four miles wide and sixteen miles 
long. But his reputation was not thus limited, called, as he often 
was, miles away to hold consultations with neighboring physicians in 
critical cases. He was a man of largo perceptions and excellent 
judgment ; devoted to his profession, sacrificing everything else to its 
pursuit, even his life. He was a large, stalwart man, possessing great 
bodily vigor and vitality, but even that could not withstand his un- 
tiring devotion. He excelled in surgery, and was remarkable success- 
ful in his operations — as well as a careful and watchful practitioner. 
He was not only respected but beloved by all who knew him. Artless 
as a child, sympathetic as a woman, charitable as a philanthropist, it 
could not be otherwise but that he would be loved. We have never 
lost from the medical ranks here one who excelled his intellectual 
acumen, sound judgment and medical skill; and this, I believe, is the 
testimony of all who knew him, both in and out of the profession. 
Zebulon W. Scrivens is dead, but his memory, like a golden sunset, 
will linger long. 



Charlbs Milton Lee died at his residence, in Kingoes, Hunterdon 
County, 11th June, 1875, in the 33d year of his age, being bom 9th 
December, 1842. He was the son of Francis K. Lee, of Baptistown, 
Hunterdon County, and grandson of William Lee, who was for many 
years a very efficient teacher of schools in that part of the country. 
He commenced the study of the profession in the office of Dr. John 
Leavitt, of Baptistown, Hunterdon County, N. J., in 1861, and in 


1868 moved to Ringoes and entered the office of Dr. C. W. Larison. 
He attended medical lectures at Geneva, N. Y., and Bellevue Medical 
College, and graduated at Geneva. 

He commenced practice as the successor of Dr. Henry B. Nightin- 
gale, Rosemont, Hunterdon County, where he was much respected and 
had a good practice, but becoming infatuated by the extravagant re- 
ports then current, of the opportunity for success in the South, he 
purchased a tract of land near Princess Ann, in Somerset County, 
Maryland, to which he removed. The adventure proved unsuccessful, 
and in the spring of 1870 he returned to his native place i^id taught 
school until March, 1873, when he entered into partnership with Dr. 
C. W. Larison, his former preceptor, where he continued doing a large 
business until within a short time of his death, which was caused by 
over-exertion in his practice. He was much lamented by his patients 
and all who knew him. He married Miss Carrie Waldron, of King- 
ston, Ulster County, N. Y., 27th October, 1874 ; from this union has 
issued a son, bearing his father's name, bom since his death, 11th 
August, 1875. 

Dr. Lee was an active, energetic and consistent member of the Bap- 
tist church, untiring in his efforts and zeal for its success. He was a 
member of good standing in the District Medical Society of Hunter- 
don County. 



NsXiSON D. W. T. Strtker died at his residence, Monmouth Junc- 
tion, Middlesex County, 20th October, 1875, in the 74th year of his 
age, being born 11th September, 1802. He was the son of John 
8tryker,'Jun., and grandson of John Stryker, Sen., of Revolutionary 
memory, who brought him up, as both his parents died when he was 
quite young. 

His grandparents both died rather before he was fully grown up, 
when he spent some time in a printing office, but not liking it, he en- 
giiged in the mercantile business, and for some time in partnership 
with his only brother John, kept store at Six Mile Run. 

He then commenced the study of medicine with Dr. Ferdinand S. 
f^ benck, of Six Mile Run, attended medical lectures in Rutgers Med- 



ical College, in New York, and graduated there. Located at what 
was then called Long Bridge, now Monmouth Junction, and com- 
menced the practice of the profession, where be resided until his 
death, attending until within a few years to an extensive practice, 
beloved by his patients, and respected by all who knew him ; a con- 
scientious and careful practitioner, until his health failing, he was 
unfitted by partial local paralysis ending in anasarca and death. His 
end was peaceful. 
He was a consistent Christian, a member of the Reformed church. 

He married Miss Williamson, daughter of Mr. George Williamson, 

of Three Mile Run, who dying, he married Miss Pumyea, cousin 

to his first wife, and daughter of Mr. John Pumyea, of Three Mile 
Run; she did not live long, and neither of them left any living 

children. He t^en married Miss Stout, daughter of Mr. John 

Stout, of that vicinity, who survives him, as does a son. Nelson D. W* 
T. Stryker. 



JoBEN Leavitt died at his residence, in Baptistown,' 4th April, 
1876, in the 57th year of his age. He was a native of New Hamp- 
shire, came to New Hampton and taught school there, and read with 
Dr. R. M. McLonahan, of that place ; after graduating in New York, 
he practiced in Asbury, Warren County, from 1846 to 1847, after 
which he removed to Ohio, where he practiced a short time, when he 
returned to New Jersey and located in Finesville, Warren County, 
where he remained until 1854 ; removing from thence to Baptistown, 
Hunterdon County, where he remained until his decease, doing a large 

amount of business. He married Miss Smith, daughter of Mr. 

James Smith, who with two children, a daughter and a son, survive 
him. He was, since living in Hunterdon County, a member of the 
District Medical Society for that County. In 1860 he was President 
of that Society, and likewise one of the Board of Censors for the same. 
He was conservative in practice, very careful and bordering on the 
expectant plan of treatment ; unobtrusive in his manners, beloved and 
revered by his patients, and the community in which he lived; es- 
teemed and respected by his professional brethren, and the most so 
by those who were best acquainted with him. He was a consistent 
member of the Presbyterian Church. 



BT J. h. BODIHE, M. D. 

Dr. Gboboe R. Robbins was bom in Monmouth County, September 
24th, 1808. He studied medicine under the direction of Dr. John 
McKelway, of Trenton, and graduated from the Jefferson Medical 
College, in Philadelphia. He practiced his profession in the village 
of Fallsington^ Bucks County, Pa., for one year, and removed to 
Hamilton Square in the spring of 1837. There he lived and practiced 
medicine for nearly thirty-eight years. He died February 22d, 1875. 
Upon the organization of the Mercer County District Medical Society, 
in 1848, Dr. Robbins was elected Treasurer of the Society. Dr. Rob- 
bins had a large and widely extended practice, and by his kindness 
and attention he secured the confidence and affection of his patients. 
He was elected to the House of Representatives of the Congress of 
the United States, in 1854, from the Second Distnct of New Jersey, and 
re-elected in 1858. Dr. Robbins w&s an esteemed physician and a 
useful citizen. 


John Mrsibr Corkelison, M. D., was bom April 29, 1802, in the 
old town of Bergen, in the present locality of the public square. Rev. 
John Comelison, his father, was pastor of the old Dutch Reformed 
Church in Bergen for thirty-five years. Toung John^s early education 
was obtained in the old Columbia Academy, the first of its kind 
erected in Bergen County, if not in the State, and was so named in 
honor of Columbia College, Kew York, and intended as a preparatory 
school for the institution across the Hudson. 

He graduated at Union College, in 1822; in the same year entered 
the office of Dr. Y. Mott, and received his degree of M. D. in 1825, at 
the College of Physicians and Surgeons. He entered upon practice 
in the same year at Bergen. His circuit of practice was large; from 
Berfifcn Point to BulPs Ferry, including Hoboken and Paulus Hook, he 
w«rnt each day, there being but two fellow-laborers besides himself in 
all that distance. Three horses were used, and were most generally 
tir*rd out ere the day's work was over. From 1825 to 1840, be thus 
continued, when he moved to Jersey City proper, and practiced hem 


down to 1862, when he ceased active medical practice. In 1832 he 
was elected to the State Legislature. 

In 1851 Governor Fort appointed him one of the six Lay Judges of 
the Court of Errors, to fill the four years unexpired term of Hon. 
Garret Wall. This position was held sixteen years, the two terms, six 
years each, and the four years unexpired term of his predecessor. 
Among the many cases before the- court, sitting three times each year, 
we notice only one—the Harmon-Thorn case, involving seven millions 
of dollars, contested by the O'Connors and Woods of New York, and 
the Vrooms, Draytons and Williamsons of New Jersey. Mr. Thom 
finally gained his case, against the vote and opinion of Dr. Cornelison. 
A Democratic Governor had appointed the Doctor, and when his first 
term expired, a Whig Governor (Olden) re-appointed him, with the 
remark, '^ He has done well, and there is no necessity to change him." 

In 1861 the North was startled with the outbreak of the late Re- 
bellion, when Dr. Cornelison felt it was his imperative duty, with 
other gentlemen of the Democratic party, to aid the Government in 
its suppression. He at once took his stand, and made a stirring ad- 
dress in support of the war measures of the general Government, in 
Masonic Hall, to a crowded audience. And all through the war, 
Abraham Lincoln had no stauncher supporter than Dr. Cornelison ; 
no one who, by every means in his power, strove to uphold the honor 
and integrity of the nation. Since then he has remained in the Re- 
publican party, though often differing with some of his friends on 
certain measures. 

In 1869 the Doctor retired from the bench of Judges, and was 
elected Mayor of the city of Bergen. This position he refused when 
one of the Judges, but now, free from that impediment, he accepted 
the nomination, and was triumphantly elected. Dr. Cornelison's father 
preached Robert Fulton's funeral oration in old Paulus Hook. 

In 1873 he was appointed Chancellor by the Legislature, a member 
of the Board of Works, and made its chairman by the Board. 

In 1874, by unanimous request and nomination, he stood as a can- 
didate of the Republican party for Mayor of the city. He quietly 
said, " I don't want the ofiice, but if the party and people want me, 
they alone must elect me, for I shall remain inactive in the matter." 
He was defeated by the present incumbent of the office of Mayor, 
Hon. Henry Traphagen. 

Dr. Cornelison was at the time of his death President of the Board 
of Regents of the Hudson County Hospital. 


In 1867 he united with St PauPs Episcopal Church, of which he 
was a consistent member. 

In his seventy-fourth year, living in a fine mansion on the hill (Ber- 
gen), with all the comforts of life, a good library, the respect of troops 
of friends, no revenges to cherish, and with charity for all, Dr. Cor- 
nelison had reached a healthy old age, and the close of his life was 
calm and peaceful. He died May £4, 1875. 



Ghablbs Dunham died in New Brunswick, N. J., 9 th December, 
1875, in the 46th year of his age, being bom in the same place, 7th 
February, 1830. He belonged to and was descended from rather a 
literary family. He was the son of Charles Dunham, who was a 
lawyer by profession, and grandson of Jacob Dunham, M. D., who 
practiced his profession thirty years or mor^ in New Brunswick ; 
greafc grandson of Azariah Dunham, of Revolutionary fame, who was 
also a resident of New Brunswick ; and he (Azariah) son of Reverend 
Jonathan Dunham, and grandson of Reverend Samuel Dunham, of 
fhe Piscataway (Stelton) church. His mother, the wife of Charles 
Dunham, sen., was a native of Savannah, Georgia; her maiden name 
was Elizabeth Morrell. The Doctor received his preliminary educa- 
tion partly at the grammar school in New Brunswick, but more 
particularly under the instructions of his father, who was a gentle- 
man of much more than ordinary attainments, and who possessed 
unusual abilities for imparting knowledge ; preparatory to commenc- 
ing the study of medicine, he spent some time in the drug store of C. 
D. Deshler, for the purpose of getting a practical knowledge of 
compounding medicines, and preparing prescriptions, and during the 
latter part of that period commenced the study of medicine under 
the instructions of A. D. Newell, M. D., and completed his studies in 
the office of ex-governor Wm. A. Newell, at Allentown, N. J., and 
was graduated Doctor of Medicine by the University of Pennsylvania 
in 1850. 

He commenced the practice of his profession in Bordentown^, N. J., 
remaining there but a little more than a year, when at the earnest 
solicitation of his father he returned to his native city, where he 


remained until his death. He married, 8th October, 1861, Mis3 
Elizabeth Hunt, daughter of Lewis Hunt, Esq., of New Brunswick, 
who survives him, and also leaves a daughter of about ten years of 

Being of a naturally retiring disposition, he would never permit 
his name to be used in connection with any political office ; consent- 
ing in only one instance, to serve as one of the board of trustees of 
the public schools, which position he held acceptably for several 


BY K. H. PAGE, M. D. 

Dr. Thomas Page, son of Dr. William Page, was bom at Cross 
Roads, Burlington County, New Jersey, June 8th, 1798. 

After having received a liberal education, he studied Medicine 
with Dr. Joseph Parrish, of Philadelphia, and graduated at the 
University of Pennsylvania, in the spring of 1821. 

Soon after graduating, he entered into partnership with his father, 
in a large and extended practice over a populous district of country, 

that taxed the powers of endurance of both father and son to the 


utmost. The partnership continued about twelve years, when it was 
dissolved, owing to the failing health of the son, who removed to 
Tuckerton in the same county, and engaged in mercantile pursuits 
in connection with the limited practice of his profession. He con- 
tinued the practice several years, but finally abandoned its active 
duties and only followed it as consulting physician for that section of 

A few years before the rebellion, be had successfully engaged in the 
milling and lumber business in Virginia. After the commencement of 
the war he passed through many vicissitudes and dangers, but finally 
succeeded in disposing of his moveable property for a mere pittance, 
and entirely abandoning his real estate, he started for his home in 
New. Jersey, thus losing the accumulations of years at one fell stroke. 
He was unexpectedly detained several weeks at Norfolk, as parol 
prisoner, during which time his family heard nothing from him ; at 
last, through the influence of some southern gentlemen who had 
formed for him a warm friendship while in their midst, by reason of 
his upright business habits and gentlemanly, genial manners, he was 


granted a permit to pass the lines, and soon gladdened his family and 
friends by bis return to his home. 

He afterward engaged in the drug basiness at Tuckerton, which 
he continued until his death. He died February 18th, 1876, aged 77 

It is not meet that I should be his eulogist, yet thus much I may be 
allowed to say. He ever maintained a high character for integrity as a 
business man, and was esteemed a safe counsellor and adviser by his 
neighbours. He serred one term in the State Legislature, at a time when 
the mental and moral standard of that body was much higher than 
it now is. He was a courteous, genial gentleman, and retained a 
youthfulness of feeling that ever caused him to sympathize with, and 
join in the innocent pleasures of the young and joyous. He was 
uniyersally respected and esteemed as citizen, neighbor and friend, 
as was most feelingly evinced by the large concourse of friends and 
neighbors that paid a heartfelt tribute of respect at his grave. 

He was twice married, and leaves two sons by his first, and two 
daughters by hb last marriage. By his family he was loved and 
revered, not only on account of filial ties, but equally for his domestic 
virtues, which are the great adornment of the true Christian gentleman. 

He was a successful physician, being a careful diagnostician and 
prompt and energetic in the treatment of disease. Commencing practice 
when patients had to be drenched with hot villainous teas, and cooling 
drinks and ice were religiously taboed, he soon saw the error of such 
treatment, and against the prejudices of patients, nurses and doctors, 
dared to act up to the convictions of his judgment, and soon had the 
satisfaction of reaping a rich harvest of reward ; not only in the 
relief of disease, but in the growing confidence and attachment of 
the community that he faithfully served, which he ever retained, not 
only by his skill and courage as a physician, but by his gentle and 
sympathetic nianners, making common cause with his patients and 
their friends in their afflictions. 

Although he never allied himself with the District and State 
Medical Societies, owing to his early abandonment of the active 
duties of the profession, he ever retained an earnest love for the 
profession of his choice, and, by reading, kept even pace with its 



BY J. R. LEAL, M. D. 

Orson Barnes was bora in 1830, in Baldwinsville, Onondaga 
County, N. Y., where he received his early education under Prof. 
Stilwell, who kept a private school for boys ; afterwards completing a 
course of study at the Syracuse Academy. 

He commenced the study of medicine in 1848, with Dr. J. V. Ken- 
dall, and afterwards was the pupil of Dr. D. T. Jones, a physician of 
celebrity in western New York. He attended three full courses of 
lectures, and graduated at the Albany Medical College in the year 
1854. After graduating he made an extensive tour through the West- 
era States, but finally returned and settled at Sncca Falls, in his 
native State. After about two years, he was induced to remove to 
Athens, Penn., where he built up a large practice. 

In September, 1861, he married the daughter of Mr. Charles 
Danforth, of Paterson, N. J., and about two years later, after the 
death of Mrs. Barnes' brother, Capt Charles Danforth, removed to 
Paterson, where he soon became engaged in active practice, which, 
before his death, became large and lucrative. 

He was thoroughly devoted to his profession and to the interests of 
his patients. His characteristics as a practitioner were rapid analysis, 
ready judgment and prompt and decided action. Courageous 
and hopeful himself, his firm tread and self-reliant air inspired hope, 
when despair was rapidly settling down upon the mind of his patient, 
while his ready sympathy incited the warmest attachments between 
himself and his patients. He was a man of fine natural abilities, of 
commanding presence, pleasing address, a good conversationalist, and 
at home in any society. He was frank and generous with his friends, 
and devotedly attached to his relatives. 

Dr. Barnes was by nature a politician. While never seeking politi- 
cal preferment, he Wds deeply interested in every contest, national 
state and municipal, and had he devoted himself to this profession, 
possessed all the traits necessary to have made him famous as a 

His last illness was tedious and severe, and attended with extreme 
suffering, which he bore with remarkable fortitude. Early in Decem- 
ber, 1874, he was prostrated by an attack of pneumonia, from which 
he made a good recovery, but too early exposed in the practice of 
his profession, brought on a severe attack of acute rheumatism, which 


resulted in disease of the heart and general dropsy, which terminated 
his life, July 23d, 1875. 

The esteem in which he was held by the oommonity, was evinced 
by the beautiful floral offieiinga, and the laige concourse of citizens 
assembled to pay the last tribute of respect and affection to his 

The following is fiom the records of Paasaic County Medical 

Society : 

At a special meeting of Passaic County Medical Society, held on 
July 24tb, 1875, at the reddence of Dr. Leal, to express the sentiments 
of the Society, in r^ard to die de^tih of Dr. Barnes; O. Warner, 
M. D., President, James C. Amiranx, M D., Seci^rtaiy — 

Resolved^ That the death of our profesmoBal friend and brother. Dr. 
Orson Barnes, fills our breasts with deep sorrow. His remoyal from 
so large a circle of admiring friends and trusting patients in the midst 
of his years, makes us feel the uncertainty of Me and tiie instability 
of all earthly prosperity. 

We tender to his bereaved family our mnoBre sympaiihy^ and will, as 
a Society, in a body accompany them at the last rites c^ reispect and 
affection to be paid to his remains. 

JResoived, Th»t the proceedings of this mfteting be published in the 
city papers, and a copy of the above resolutions be forwarded to his 



Samukl akt TnoKKTOV, M. D., son of Josc^ and Mary Thornton, 
of Buckingham, Buck^ County, Pennsylvania. In this place he was 
born, A. D. 1791, and lived there until he attained his majority. 
Was educated at the Doylestown Academy. Studied Medicine under 
Dr. Wikon, of Buckingham. Graduated in 1816, at the TJnivermty 
of Pennsylvania. Directly afterwards moved to Mooreitown, Burling 
ton County, Kew Jersey, and there practiced medicine until he died, 
March 19, A. 0. 1S5S. 



T>n. John OnTHWs died at Boonton, September 12th, 1875; hewnsthe 
•on of .Tonathan Grimes, and was bom at Parsippaoy, Morris Cotmty, 
\n 1^02. He received a certificate to practice medicine, frcan the 


State Medical Society, in 1827. First practiced at Newfoundland, 
N. J., but since 1833 has practiced in Boonton. 

He was remarkable for his strong convictions, and the boldness and 
pertinacity with which he followed them. He early became a fearless 
and outspoken adyocate of the anti-slavery doctrine, and played an 
important part in the agitation of that perplexing political question. 
He frequently aided slaves to escape, and his house was what was 
termed a station on the ^^ Underground Railroad." He was frequently 
ill-treated and mobbed ; and once arrested by the Sheriff of Essex 
County, for aiding in the escape of fugitive slaves. He gave bonds, 
but for some reason was never tried. He was President of the first 
Anti-Slavery Society in the State. In 1844 published the N. Y. Free- 
man, which continued until 1850, when other journals took up and 
advocated the question. 

He was an early and strong advocate of the Temperance cause ; he 
strongly condemned the use of stimulants, as practiced in the profes- 
sion twenty years ago. It was a satisfaction to him that he lived to 
see the profession adopt his views in. a great measure, on the 
question of stimulants ; and the country at large uphold his views on 
the great political question. 

Through nearly the whole of his adult life he abstained from animal 
food. Whatever may be the facts or theories as to the value of 
animal food, it is clear it did not impair his vigor of mind or body, 
for he always had a large and laborious practice, and when an old 
man he performed more professional labor than most young men are 
able to endure. 

His quiet, grave manner, plainness of dress, early and persistent 
advocacy of temperance and anti-slavery, served to render him un- 
popular in some respects, for the greater part of his life. But all, 
whether in or out of the profession, recognized his ability as a practi- 
tioner. He performed many important surgical operations, and in 
both surgery and obstetrics was for a long time considered authority 
in this part of the country. 

During his whole life, in his intercourse with the profession and the 
world's people, he was a man of honor, truth, and the strictest moral- 
ity. At the time of his death he was highly esteemed and loved. 




James Vandebpool was born in New York city, November 4th, 
1841, and died in Yokohama, Japan, January 14th, 1876. When he 
was one year old, his father, Beach Vanderpool, removed with his 
family to Newark, N. J., his native town. 

At the age of 13 years, James was sent to school to Mr. Charles M. 
Davis, at Bloomfield, N. J., and afterwards entered the Mount Pleas- 
ant Military Academy of Mr. Maurice, at Sing Sing, N. Y. In the 
year 1850 he passed his examination for admission to the Freshman 
Class of Yale College. He remained at Yale during two years, and 
in 1861 became a member of the Junior Class of Williams College, 
Massachusetts, from which he was graduated in the class of 1863. 

On quitting college, he began the study of medicine in the office of 
Dr. Isaac A. Nichols, Newark, N. J., with whom he remained about 
one year, when he matriculated at the College of Physicians and Sur- 
geons (Columbia College), in the city of New York. He received his 
degree of M. D. in the year 1866, and, with some fifteen or twenty 
other young physicians, he became a competitor for the position of 
House Physician of the old New York Hospital, recently demolished, 
which stood on Broadway facing Pearl Street. The examination was 
a very severe and impartial one, but Dr. Vanderpool succeeded in 
obtaining the prize ; and for upwards of two years he acted in the 
capacity of House Physician of that institution. In the year 1869 he 
removed to Newark, and commenced the practice of his profession. 
He was elected a member of the staff of St. Barnabas* Hospital, and 
soon after resigned that position in order to accept a membership on 
the medical Staff of St. MichaePs Hospital. In the same year he was ap- 
pointed a Brigade Surgeon, with the rank of Major, on the staff of 
Brig. General Plume. 

In the year 1873 he went to Europe, making the tour of the British 
Isles, and visiting the Continent. 

On the 29th of November, 1873, he sailed from the port of New 
York in the barkentine James Condie^ (new), bound for Yokohama, 
Japan, with the intention of making a voyage around the world for 
the benefit of his health. No noteworthy incident occurred until 3 
o'clock, A. M-, of April 1st, 1875, when the barkentine struck a coral 
reef off the Island of Boeton, near the large island of Celebes, Malay- 


sia. The vessel was abandoned by the captain, and all hands took to 
the boats, and rowed some 15 miles to a small island, which they found 
to be inhabited by savages. It was with difficulty that the barbarians 
were persuaded to allow the shipwrecked voyagers to land. They 
remained for two weeks on this island, sheltered by an old thatched 
fishing shed standing near the sea shore. On the 14th of April they 
were rescued by an Italian man of war, a corvette, the Vettar Pisaniy 
and were carried to the Dutch island of Amboyna. The commandant 
of the corvette generously offered Dr. Vanderpool an invitation to 
accompany him to Yokohama, which was thankfully accepted as far 
as Hong Kong. On the way thither, the corvette stopped at Ternate; 
and remained for some time at the large almost unknown island of 
New Guinea. At Hong Kong, the Doctor took a White Star Steamer 
to Yokohama, where he arrived on the 10th of July, having lost the 
greater part of his baggage by the shipwreck: He soon made the 
acquaintance of Dr. Eldridge, the Physician in Chief of the General 
Hospital at Yokohama, who kindly offered him the position of Assist- 
ant Physician of the Hospital, until he could make his arrangements 
for the future. He accordingly moved his quarters to the Hospital, 
and had apartments in the building. On the morning of January 
14th, 1876, the Japanese servant went to his room and found him dead 
in his bed. Ho was buried in the foreign cemetery, at Yokohama, 
the Rev. Mr. Miller, of the Church of England, of which Dr. Vander- 
pool was a member, reading the burial service. His remains will be 
exhumed, and brought to Newark, N. J., for interment. 


BT R. H. PAGE, M. D. 

Dr. Benjamin Harris Stratton, son of Dr. John L. Stratton and 
Anna H. (who was a daughter of Dr. James Stratton, of Swedesboro, 
Gloucester County, New Jersey)'was born in Mount Holly, Burlington 
County, N. J., February 6th, 1804. 

His father was born in Fairfield, Cumberland County, N. J., Febru- 
ary 23, 1778. He had the advantages of a good school, of which he 
made the most; and pursued the study of medicine with Dr. James 
Stratton, the maternal grandfather of the subject of this memoir. 
After attending the regular courses at the University of Pennsylvania, 



be graduated in the year 1800, and shortly after, located in Mount 
Holly, where he sacceasfally practiced his profession (with the excep- 
tion of a short period of six months, during which he was in Burling- 
ton City, associated with Dr. Nathan W. Cole) until a few years before 
his death, which occurred on August 17th, 1845. 

The son, Benj. H., was prepared for college at Baskenridge, N. J., 
which then enjoyed a high reputation as a preparatory school ; and 
graduated at Princeton College in September, 1823. Very soon there- 
after he commenced the study of medicine with his father, and grad- 
uated at the University of Pennsylvania in the spring of 1827. Soon 
after graduating he entered into partnership with his father as a 
medical practitioner. They continued together until a few years 
before the father^s death, when the infirmities of age, made premature 
by his onerous life work, caused the father to withdraw from active 
practice ; and the son, in addition to the labor, hardships and responsi- 
bilities of an already large and increasing practice, assumed the 
duties laid aside by the father ; and how well, conscientiously and 
successfully they were performed, the love, veneration and respect of 
the community he served so long, most beautifully tells. 

He continued his professional labors through all the changes and 
vicissitudes of a half century up to the commencement of his last 
illness, and then unwillingly laid them aside, only at the commands 
of his attending physicians. After several months confinement and 
suffering, with a complication of diseases, borne with the resignation 
of a Christian gentleman, he died December 31st, 1875, aged 72 years. 

It could be truly said of Dr. Stratton, that he was a high-toned, 
honorable gentleman, just and upright in all his dealings, possessing a 
high sense of integrity, from which he never swerved. He was a 
cheerful, genial companion, warm and true in his friendships, and 
compassionate and considerate of the feelings of others; elated with 
their joys and saddened with their sorrows, in a word the golden rule 
" do unto others as ye would they should do unto you,'' was his 
guide, shield and buckler through life. What higher encomium could 
be given ? 

In his professional life the same characteristics that distinguished 
him as a man, honor, honesty and integrity were prominent, with an 
enthusiastic love of his profession that was shown in his practice, in 
his daily intercourse with physicians, in the meetings of the Medical 
Societies, in his observance of the laws of medical etiquette, and at 
all times and seasons he was its devotee, advocate and defender. 


As a physician, through all the years of his practice he held a 
prominent position among . those of the State. He was one of the 
founders of the Burlington County Medical Society in 1829, was 
elected President several times, and served as Treasurer for many 
years. He was almost always present at its stated meetings, and 
actively participated in the proceedings, and when young physicians 
were elected as members, he would extend to them a cordial greeting, 
and in all their after professional intercourse with him, be to them 
friend, guide and counsellor, as the writer remembers with gratitude. 

He was a member and regular attendant of the meetings of the 
New Jersey State Medical Society, and was elected President in the 
year 1838. The physicians of the State will remember him as an 
active co-worker in all their labors, and as a gentlemanly, genial com- 
panion, whom they had learned to love and esteem. 

As a practitioner, he was successful in the treatment of disease, and 
not only won the confidence of his patients by his skill, but their 
hearts by his kindness and sympathy. He was noted for his ready 
resource in the use and adaptation of ^ domestic remedies' as adjuncts 
in the cure of disease, and as a prescriber of officinal standard reme- 
dies in their combinations and adaptability to the disease under 
treatment, he had few or no superiors. He acquired an enviable 
reputation as accoucheur, and was very skillful in the use of the 
forceps. And prompted by his enthusiastic love for the profession of his 
choice, almost of his inheritance, he through all the long years of his 
arduous labors, was a constant reader of the current medical literature 
of the day, and thus kept pace with the material advancement of 
medical science. Although he kept no record of his cases, yet, haviug 
a retentive memory, his mind was stored with a great amount of prac- 
tical knowledge that he was ever ready to impart for the benefit of 

He lived the truth of the homily of Bacon : " I hold every man 
debtor to his profession ; from the which, as men do seek to receive 
countenance and profit, so ought they of duty to endeavor themselves 
by way of amends to be a help and ornament thereto." Dr. Stratton 
was married May 11, 1829; his widow and two daughters survive 

The following preamble and resolutions, of the Burlington County 
Medical Society, inadequately express the sentiments of honor, love 
and esteem inspired by him among his medical brethren during his 



life, and their deep feelings of regret and sorrow at the time of his 

BuRLiKOTON County Medical Society.— At a ppcciiil meeting of 
the Burlington Count; Aieilicai Socict;, called for the purpose of 
attendio;; the funeral of Dr. B. n. Strntton, the following preamble 
and resolutions were unaniinously adopted : 

WncREAS, Dr. Benjmiiin II. Strntton baa l)een removed by death in 
the fullness of years and the ripeness of profvcsional bonore, we. the 
memUcrs ofthe Burlington County District Mcdii-al Society, recognizing 
Lim as one of the founders of tlie Sociciy in 1830, and its firmo^t and 
most efficient supporter, both by word and deed, through evil and 
good report, feel that by his dentil the Society liaa met with an incal- 
culable loss that time will mitigate, but never entirely icmedy ; and 
that we, bis fiienda. associatrs and professional brethren, grieve with 
a sincere ROd heartfelt grief for him as a friend, companion, instructor 
and couTiBellor, for many of ua remimber wilh gratiludo, when enter- 
ing upon our profussional career, that not only in the meetings of the 
Society, but at all times and seasons, he was ever ready to draw from 
the general storehouse of his profeesional experience, lessons of ■wis- 
dom and counsel for our benefit and guidance, and his memory 'will 
ever be held in esteem and reverence ; and 

WnBUBAS. Our profesnion is endeared to ns by years of toil, by 
responsibilities met, by hardships endured, by triumphs achieved, and 
by associations of professional and social intercourse wilh each olher, 
it is meet that its members, when one of their number, one of the 
oldest practitioners in their midst, who, through a long life of profes- 
sional labor, has to the full, partaken of its responeiblliiies, hardahips 
and triumphs, and whose cheerful disposition, genial manners and 
honorable professional inlercouree has won our respect and esteem, 
and who, for the lost half century has moved in and out amongst this 
people, mingling in their joys and partaking of their sorrows, and as 
the akillful physician with an ever willing mind and ready hand 
assuaged their sfflictinns and sufferings, is removed from among us by 
death, do pay a heartfelt tribute of respect to his memory by mingliog 
our grief with that of his afflicted family aad many sorrowing friends ; 

Beadied, That we attend bit funeral in a body, and wear the usual 
badge of mourning. 

lieaohed. That the secretary be authorized to transmit a copy of 
these resolutions to the family of the deceased, and to the Mount 

n^ii- -KT 1 — J n — ^gj, pjpeia. 


,T DB. C. V. UOORB. 

1 near the village of Stillwater, Sussex 
Uay 29tb, 1832. At as early ago he 
ndy. All the advaotagea in this respect 


were obtained in the public schools at Stillwater, where, under 
the able tutorship of John D. Reynolds, he and many other 
scholars laid the foundation for the different professions He 
studied medicine with Dr. John J. Linderman, of Dingmans, 
Pike County, Pennsylvania, and graduated at the Jefferson Medical 
College of Philadelphia in 1858. The same year he settled in practice 
at Flatbrookville, Sussex County. The same year he married the 
daughter of his preceptor, the late Dr. John J. Linderman. With the 
exception of about five years his whole professional life was spent at 
Flatbrookville. Ever ready to go upon call, his kindness and assiduity 
was proverbial. He persevered with the professional harness on. 
From exposure he contracted cold about the 15th of February last ; 
double pneumonia set in ; the attack was severe, and the case well 
nigh hopeless the first week ; but from the lung trouble he appeared 
to be making a satisfactory recovery, as his lungs seemed entirely re- 
lieved. Some gastric weakness and want of nutrition remaining, he 
did not recover so as to be out, and rather unexpectedly on Saturday, 
March 11th, some cerebral symptoms manifested themselves, soon fol- 
lowed by convulsions, and he died on Monday, the 13th of March, 
1870, in the 44th year of his age, mourned and appreciated, as evinced 
by the numerous and sorrowing concourse of neighbors and friends 
that attended his remains to there last resting-place. 



To Chairman of Standing Committee^ &c. : 
. The general health of the county of Bergen has been 
about as good as the preceding two or three years. As 
regards the village of Hackensack, and its immediate 
surroundings, my experience and observation corres- 
pond with that of Dr. C. Hasbrouck, who notes "the 
entire absence of all epidemic influences— or to speak 
more correctly, perhaps — the entire absence of all 
manifestations of such influence, in the prevalent 
diseases of the past year." Indeed, we have had no 
epidemic of any kind, excepting during the past winter, 
the remarkable prevalence of catarrhal influenza. 

A few cases of pertussis, scarlatina and diphtheria 
have occurred, but as far as I have been able to learn, 
have been isolated. There have been less malarial 
fevers the past year than usual. Intermittents have 
prevailed to a limited extent, but the more common 
and serious results of malarial poison have been no- 
ticed in the different forms of neuralgia, which yield 
only to large and repeated doses of quinine. Pneu- 
monia, pleuritis, and the various bowel affections, have 
been less prevalent than usual. 

In regard to malaria. Dr. H. A. Hopper, of Hacken- 
sack, says : "I saw and treated a great number of 
malarial cases of a peculiar character, both pernicious 


and masked fevers ; some of them coming fairly under 
the nosological arrangement of typho-malarlal. It has 
no doubt fallen to the lot of many members of the 
profession, who have enjoyed several years of observa- 
tion, to have met with some of the same peculiarly 
obscure forms of disease, in which it seemed impossi- 
ble to designate any distinct type of fever, because of 
the absence of distinctly marked pyrexia or apyrexia ; 
running their course without any, or with only slightly 
developed febrile manifestations ; disturbing certain 
nerve centres, and producing local neuralgia, or in the 
absence of special neurosis, nothing more than a gen- 
eral malaise. In the months of June and July, I 
treated more than two dozen such cases, sometimes 
assuming the quotidian and tertian types, and in three 
or four of them a quartern form. The disease was 
more prevalent among children than adults ; several 
cases being complicated with severe convulsions, re- 
sulting in infantile paralysis with two of them. Both 
recovered in about two months, more from the recuper- 
ative power of natural growth and development, than 
by any line of medication employed. No one will, I 
think, intimate that organic diseases may not be com- 
plicated by a supervening attack of malarial fever, but 
they are so liable to simulation while the system is 
under malarial influence, that it becomes a matter of 
profitable study to note the peculiar vagaries of mala- 
rial attacks. In some instances the attacks appeared 
more like local muscular rheumatism ; the successful 
result, however, of quinine treatment being conclusive 
of their malarial origin. The peculiarity and number 
of malarial cases which came under my notice during 
the summer of 1875, suggested very strongly the 
importance of studying both the general and special^ 


etiology of the diseases. To discuss it would reqnire 
more time and space than would be allowed to tliis 
report. I .have no very deep share, however, . in the 
opinions of that class of thinkers, who always associate 
malaria with swamps, and other low lands, and find 
in them the almost exclusive and prime factors in its 
production. I do not doubt that it may sometimes be 
epidemic, but feel well assured that it is more com- 
monly endemic, and that its origin is more frequently 
than will be readily admitted, in and around our 
dwellings ; the products in such cases, to be classed 
among preventable diseases. I am well convinced 
that many of the cases to which I have here alluded, 
were the direct result of the inhalation, during the 
hours of sleep at night, of an atmosphere poisoned by 
the mephitic gases evolved from out-door water 
closets, in close proximity to the open windows of 
sleeping apartments. The sooner we can, by authority 
of general and local laws, enforce an observance of 
sanitary regulations, in regard to many domestic 
causes of this and kindred poisons, sometimes in 
water supplies from wells, and at other, from sewer 
gases, the better will be the health of our population, 
in country, town and city. In the treatment of the 
cnst^a named, as I have previously indicated, I relied 
almost entiivly on the use of sulphate of quinine, for 
the early bivaking up of the attack ; and believing 
tliat prompt treatment is the most reliable method for 
provt»uting oi^anio lesions, and thus the pernicious 
forms of the disease, I frequently prescribe forty 
gmius in twelve houi^s for adults. Idiosyncrasies may 
be found, in which, on account of intolerance of the 
ivmtnly in even small doses, I am compelled to resort 
to 8\ilphuto of oinchonia ; a remedy which in my 


hands has not proved very satisfactory, except as a 
prophylactic. In several cases of young children, I 
have used drachm doses of the fluid extract of 
eucalyptus globulus, with very good results." 

From Coytesville and vicinity. Dr. A. Clendenin 
reports no epidemics ; a few cases of measles and of 
scarlatina, and two of variola ; pneumonia, pleurisy 
and bronchitis less than usual ; parotitis has been 
quite prevalent. There have been a number of cases 
of rheumatism and arthritic complications; of mala- 
rious fevers a large number of cases almost exclusively 
tertian intermittent, the remittent type mostly attend- 
ing upon some distinct organic inflammation, as of 
the lungs, liver, or kidneys. In the treatment of 
intermittent Dr. Clendenin says: ''I give sulphate 
of quinine in solution, two grains to the teaspoonful 
of water, saturated with camphor, which counteracts 
the cerebral excitements often following the use of 
quinine. A rule I always observe, is the non-adminis- 
tration of quinine shorter than six hours pridr to 
expected recurrence of paroxysm, or if the cold is not 
sufiiciently distinct, then seven hours ahead of the 
fever. I have never found it necessary to give more 
than ten grains during the twenty-four hours, gener- 
ally not more than five grains. Given, as I said before, 
in solution, and generally in connection with a small 
amount of strong hot coflfee, which destroys the taste 
almost entirely, and assists the rapidity of the action of 
the quinine. After first omission of paroxysm, one dose 
six to eight hours in advance of hour the next one is 
due, and after this for alternate times covering three 
weeks. During this time, I generally use dilute nitro- 
muriatic acids, and attend to the general health, &c." 
Dr. Clendenin also reports twenty-three cases of 


diphtheria occuring in his practice during the past 

From Park Ridge and vicinity, Dr. H. C. Neer re- 
ports, that the spring and summer mouths of 1875 
presented notliing worthy of particular attention 
in the general class of diseases, excepting, per- 
haps, the continued decrease of intermittent fever, 
which has been much less prevalent than in former 
years. At the beginning of the past winter, diph- 
theria and scarlatina made their appearance in dif- 
ferent localities, and continued to be more or less 
prevalent through the winter and early spring. Many 
of the cases have been severe and complicated. The 
Doctor reports as having had under his care, about 
forty of the former, and sixty of the latter — two cases 
of scarlatina and three of diphtheria terminating fa- 
tally. In addition to the usual remedies, the Doctor 
says : " I think I have derived much benefit from the 
use of Salicylic Acid, used externally and as a gar- 
gle." Pneumonia and bronchitis have not been 
unusually prevalent or severe the past winter, except- 
ing with small children. The Doctor also calls atten- 
tion to the frequency and severity of inflammatory- 
throat affections during the months of February and 
March, exhibiting a very decided malarial element, 
having regular intermissions. The throat would be 
very comfortable in the morning, and the patient feel- 
ing nearly well ; in the afternoon fever would set in. 


reports: ''The vernal months remarkably healthy; 
parotitis the only epidemic. From the middle of 
June till the second week in October, there was no 
respite to disease incident to this portion of the year. 
The prevalence of dysentery was noteworthy, ap-. 
preaching an epidemic. Common membranous sore 
throat has been exceedingly prevalent. Diphtheria 
has been rife ; its fatality in some localities fearful. I 
was in hopes to report all my cases favorable, but, 
unfortunately, lost two cases in one family— twins, 
under four years. Poor nursing and supreme indif- 
ference too often appends a stigma to efforts that 
might otherwise have yielded a golden harvest. The 
''Chlorine" treatment claims more than a passing 
notice. Large doses of tinct. ferri. chlor. et potasssB 
chlor. administered every ten or fifteen minutes, as a 
rule, acts like magic. The free use of ale or beer, and 
"pickle pork" externally, should not be despised. 
Grargles and topical appliances are uncalled for. 
Quinine, in some cases, may be given with propriety. 
Pursuing this line of treatment the glands of the neck 
seldom enlarge perceptibly. Scarlatina has not as- 
sumed the form of an epidemic, but it has been quite 
prevalent during the entire year ; one case of the ma- 
lignant variety fatal in fifty-six hours. Variola, ru- 
beola and varicella have occasionally made their 

I have received no direct information from the other 
parts of the county, and of course cannot report con- 
cerning theiH. I have reason to believe, however, that 
diphtheria has prevailed extensively in the lower part 
of the county, particularly in the village of Carlstadt 
and vicinity. 

I have endeavored to secure answers from the mem- 


bers of our "District Society" to the questions pro- 
pounded by the "Standing Committee of the State 
Society," but have onlj'- received replies from three,, 
viz : Drs. Hasbrouck, Clendenin and Ourrie. 

As to " t7ie vahce of topical remedies in malignant 
sore throat,^^ Dr. Hasbrouck says: "It is presumed 
that the committee refer not to any one specific dis- 
ease, but to the condition of malignancy which forms 
so prominent a feature of the sore throats of different 
diseases. Assuming this to be the fact, and assuming 
also that the committee desire an answer based entirely 
upon the experience of members, I would state that 
when I began to practice medicine in 1839-40, it was 
the general, if not universal practice, in the anginose 
and malignant forms of scarlatina, to employ various 
topical remedies to the throat by means of sponge, 
probangs, &c., for the purpose of arresting the ne- 
crotic process, and to encourage the separation of 
sloughs and the cicatrization of the resulting ulcers. 
For this purpose solutions of nitrate of silver or sul- 
phate of copper, the black wash, hydro-chloric acid, 
&c. , besides various emollient and astringent gargles, 
were daily employed. My own experience in the use 
of such topical measures, particularly those that re- 
quired the employment of sponging, probangs, &c., I 
must confess were never very satisfactory, although 
in deference to the general opinion and practice of the 
profession, I continued to employ them. Some eigh- 
teen or twenty years later, perhaps, or about sixteen 
or eighteen years ago, diphtheria first made its appear- 
ance in this county. The disease was of a most malig- 
nant type, and very fatal, and spread rapidly through 
the county. It was at that time regarded mostly as a 
local disease, and the topical application of remedies 


was not only generally resorted to, but was regarded 
as an important if not an essential part of the treat- 
*ment. The nitrate of silver, either solid or in solution, 
was the remedy mostly nsed. As far as my own 
observation and experience in the use of this means 
of treatment extended, I must say that T was never 
able to see the favorable results that were claimed for 
it ; and as the profession became more and more fixed 
in the opinion that the disease was a constitutional or 
blood disease, of which the sore throat and mem- 
branous exudation were but the local manifestations, 
I gradually ceased to use the caustic solutions by 
means of brushes, probangs, &c., and contented 
myself, so far as local treatment was concerned, with 
gargles, and the internal use of acidulated drinks. 
The treatment which I have adopted for several years 
past, is about as follows : 1st. Strict attention to ven- 
tilation, cleanliness, and the free use of disinfectants, 
such as carbolic acid, &c. 2d. The regular and fre- 
quent administration of food, particularly eggs, beef- 
tea, and milk, with or without alcoholic stimulants, as 
the case may require. 3d. General tonics, as quinine, 
in small doses, but more particularly the tinct. fer. 
sesqui. chlorid. in a solution of the chlorate of potash. 
4th. Chlorine water in doses of from 3i., 2ss., with an 
equal bulk of water, given every half hour. This last 
remedy, for my first employment of which, by the way, 
I am indebted to your own suggestion, I have found 
exceedingly pleasant and effective in cleansing the 
throat ahd correcting the putrid and offensive odor. 
In employing the tinct. of iron as above suggested, I 
used to think that its efficiency was due to its general 
or constitutional tonic action — the same as in ery- 
sipelas. But, for some time past, I have been led to 


believe that much of the benefit resulting from its use, 
is due to its direct local action, and that it should, 
therefore, be regarded as a topical as well as a consti- 
tutional remedy. Latterly I have become confirmed 
in this opinion by the results of the use of this remedy, 
and of others similar to it, in the, practice of other phy- 
sicians. Some months ago I was called in consulta- 
tion with my friend Dr. DeMund, of Wort^ndyke, in 
this county, to see some cases of diphtheria under his 
care. The doctor has, I think, been unusually success- 
ful in his treatment of this disease. His treatment, 
however, differs in no respect from that which I had 
been in the habit of adopting, except in the size and 
frequency of his doses of the tincture of iron. Instead 
of giving it in doses of from five to fifteen drops in a 
saturated solution of chlorate of potash every two or 
three hours, as had been my usual practice, he insisted 
upon the necessity of giving from ten to thirty drops 
or more, every ten, fifteen or twenty minutes, night 
and day. Now, it seems almost incredible that these 
large and frequent doses can be appropriated and 
utilized by the system. So far as constitutional effects 
are concerned, I think the smaller doses of the tincture 
of iron are as much as can be of any value ; and it is 
more than probable, I think, that the exceptionally 
favorable results that Dr. DeMund is able to report, are 
due to the direct topical action of the remedy as a 
tonic and antiseptic, this action being intensified and 
assured by its frequent application. The Doctor is 
located in the upper and more elevated portion of the 
county — a district exceptionally free from malarious 
influences, and his success in diphtheria may, per- 
haps, be due, to some extent, to these favorable con- 
ditions. Nevertheless, I cannot but believe that it is 


to a greater degree the result of the direct disinfectant 
and alterative action of the chlorate, &c. , frequently, 
almost constantly applied, in the act of deglutition. 

In this opinion I am still further confirmed by the 
published results of very similar treatment in the 
experience of Dr. Biljington, of New York. In a 
paper recently read by Dr. B., before the N. Y. 
Academy of Medicine, and published in the> N. Y. 
Medical Record, of March 26, 1876, he maintains 
that diphtheria is primarily a local affection, and that 
the local disease of the throat is itself the source of 
the constitutional manifestations, the same as chancre 
is itself the source of the constitutional infection in 
syphilis. In conformity with this doctrine, his treat- 
ment is based upon the principle of local disinfection, 
the indication being to destroy the contagion, and 
combat the absorption of the poisonous elements from 
the spot at which the local disease is manifest ; failing 
in this essential, he thinks that constitutional meas- 
ures are useless. The list of remedies he employs for 
this purpose, are the tincture of the chloride of iron, 
lime water, glycerine, chlorate of potash, carbolic 
acid, salicylic acid and sulphite of soda ; the first 
named being by far the best as a local disinfectant. 
He also lays great stress upon the mode of emplojdng 
these remedies ; and for the purpose of securing their 
best local influence, he advises their internal use, 
rather than by the employment of brushes, sponges, 
&c. The topical use of spray, however, he advises in 
cases in which it can be used. Another point upon 
which he insists as a matter of prime importance, is 
that in whatever combination these remedies are used, 
they must be taken or used in very frequent doses, 
that is, as often at least as every half hour. 


The success which Dr. B. reports is certainly excep- 
tional. Of 124 dispensary cases, he reports 90 recov- 
eries, and of 19 cases occurring at the same time in 
his private practice, all recovered but one. The 
average duration of his cases is six days ; and he 
believes that by early, thorough and faithful persist- 
ence in these measures of local disinfection, he 
prevents systemic infection, and subsequent laryn- 
geal and other complications. 

To sura up my opinion, then, as to the value of topi- 
cal remedies in malignant sore throat, I would say 
that I regard them as of great value, more particularly 
when very frequently applied by administering them 
internally, or at least without the mechanical irri- 
tation and violence that almost necessarily attend the 
application of these remedies by means of brushes, 
swabs and probangs. 

In reply to the second question of the Standing 
Committee, viz : ''In what morbid conditions do you 
rely upon calomel as a therapeutic agent ? " I scarcely 
know what answer to make. 

From 26 to 35 years ago, there was scarcely a 
morbid condition of the system, or a disease of any 
kind, in which I did not resort, in common with the 
rest of the profession, to the liberal use of calomel. 
In inflammations especially, whether acute or chronic, 
I regarded it, next to bleeding, as our main reliaiic- 
both to arrest the attack, and also to promote 
absorbtion, and elimination of the products ui 
inflammatory action. For many years past, ]\o\\ 
as I have learned that these diseases get weJi 
certainly without calomel as with it, I have cea^s* . 
give it, except in very exceptional cases. Ev»^^ 
those diseases in which the alterative eflfects of u 


cury may be desired, T am in the habit of using the 
mercuiy with chalk, blue- mass, corrosive sublimate, 
or the protoxide of mercury, preparations which are 
much more manageable and safe. There is one dis- 
ease, however, in wliich I always give calomel, and that 
is iritis. In this disease, I do not think anything can 
supply its place, whether the inflammation be acute 
or chronic, or of syphilitic origin or not ; the effects 
of calomel in its treatment are uniformly so prompt 
and certain, that I would no more think of treating a 
case without it, than I would treat an intermittent 
without any of the preparations of bark ; and this is, 
perhaps, the only disease in which I can be said to 
rely upon calomel as a therapeutic agent. 

Cholera Infantum is another disease in which I 
sometimes give calomel. In some cases,, given in com- 
bination with bismuth and pepsine, it seems to quiet 
the irritable stomach, and to promote the healthy 
action of the liver and intestinal tract. I do not, how- 
ever, regard its use as at all indispensable. 

But it is as a purgative, perhaps, that at the present 
time, I most frequently use calomel ; and as such, in 
some cases, particularly in children, its effects are 
truly admirable. Children from iive to ten years old, 
will often be seized with a sharp fever, with torpid 
bowels, a dirty and slimy tongue, entire loss of appe- 
tite, and very offensive breath. In such cases, a good 
calomel purge will oft^n relieve these symptoms at 
once, and pennanently. 

Dr. Clendenin, of Coytesville, contributes two sur- 
gical cases of interest. 

A. 8. BURDETT, Reporter. 
Hackeksack, May, 15, 1876. 


Cases by Dr. A. Clendenin. 

Cask I. Annular Stricture, — On the 2d January, 1875, 1 was called 
to Antonio J. Walbman, bookbinder in Coytesvllle ; case of six ure- 
thral strictures, and five fistulous openings in groin and perineum, 
the line of the strictures covering two and one-half inches, almost 
entirely in the membranous portion. Each stricture was somewhat 
dilated with large conical pointed sound, after continuous pressure. 
After exploration. No. 3 Urethretonie was passed, and strictures 
divided. CharrierPs penis glass and pump were used before operation 
and until final cure. After the division of all the strictures, a slippery 
elm dilator was almost constantly kept in, in order to control the size 
of the urethra during cicatrization, and in a soothing manner. This 
is specially required, because twice before— once in Berlin and once in 
New York— this man had been operated upon ; but in consequence of 
his peculiar diathesis— both father and brother having suffered (one 
to fatality) with calculus, and this one having such tendency, and 
being spasmodic — beside the neglect of continuous dilatation, his re- 
lapses had been worse than the primary. Within two weeks he was 
off my list. But a few days since, I examined him, and find him, 
after the space of more than a year, in the enjoyment of perfect 
health and fuU urethral calibre. I especially recommend the slippery 
elm dilator and the penis glass. The fistulas by the latter were con- 
stantly relieved, and by the injection of a weak solution of sulph. 
iron quickly healed. 

Case II. Scirrous Cancer d la Base.— On the 3d February, 1876, 1 
was called to case of the above — a woman over 70 years of age ; 
opening 3 by 3^ in diameter ; growth noticed and pains remarked 
about two years. The case had been diagnosed and operation recom- 
mended by more than one physician during this time. Prior to call- 
ing for me, she lost some 18 or 20 ounces of blood, and one physician 
called upon had (in consequence of age and anaemia) judged an oper- 
ation impracticable. When I saw her I gave her sulphate of iron and 
quinine, arranged a support for the point of cancer, viz: left breast- 
prescribed liberal nutritious diet, and recumbent posture. 

On the 11th Feb. I found her blood enriched and her general tone 
improved. On that day I operated upon her, lashed in my operating 
chair; the loss of blood was exceedingly small, she was under the 
infiuence of chloroform ; the operation was slow, consequent upon 


ligation of arterial branches immediately after division, beside the use 
of sesquioxide of iron. The entire breast was involved and removed, 
beside three intercostal glands and one ante-axillary complication. 
The arm was bound behind the back, so as to draw tense the pector- 
alis major, the incisions were in line for cicatrization to correspond 
with its fibers, in order to expedite healing and give a fall toward the 
sternum for discharges. Length of cicatrix now is 9^ inches ; the 
weight of excised two ounces less than two pounds ; the wound was 
-sutured in lower end ; kept constantly wet and cool with solution of 
*' bromo-chloralum," one to eight of water ; the surroundings were 
daily painted with tinct. iodine ; her bowels regulated ; no stimulation, 
but liberal nutritious diet, and syr. ferri. iodid., twenty drops with 
water three times a day. Thirty days from date of operation, the 
cicatrix was perfect, and to-day (April 11, 1876) she is walking 
around with increase of flesh, in good general health, attending to 
household duties. There was an enlargement of the axillai^ glands, 
which passed away, and no signs of recurrence appear. 

By Dr. D. A. Currib, op Enolewood. 


There has been rather more than the average amount of sickness 
during the past year, commencing with May let, 1875. I had an 
unusual number ill with pneumonia of a decided malarial type, 
affecting principally the younger members of the community. 

During the latter part of May, running through June and July, 
there was also existing through this section, hooping-cough, bron- 
chitis, acute rheumatism, an occasional case of scarlatina, and various 
other minor troubles of short duration. 

August brought an unusual number of intestinal disorders peculiar 
to children — tonsilitis, &c. Sore throats were also very prevalent 
throughout the fall and winter months. 

September brought a few cases of intermittent and remittent fevers, 

but during the winter months they gradually assumed the typho- 

malarial type, eleven cases occurring in almost as many different 


families, ruDniDg a course of six, ten, and even fifteen weeks' duration, 
whicli is something bran-new in this part of the country. 

I was principally engaged in caring for these and a few more candi- 
dates for hooping-cough and measles, which brought me as far as 
December 1st ; and in connection with this, will state, that I found 
Ext Conni. Fid., in small doses, serviceable in allaying the paroxysms 
of hooping-cough and in shortening the disease, and when the bron- 
chial secretion is very profuse, Ext. Belladon. Fid. has proved of great 
service, and in conjunction with it, oftentimes, Hydro-cyanic Acid acts 

During the summer and fall months I treated over one hundred 
cases of the disease, so I am speaking from my own experience. 

December brought an epidemic of influenza, sore throat, pneu- 
monia, bronchitis, acute rheumatism, and a continuance of hooping- 

January and February seemed to bring nothing of a contagious 
nature except mumps, of which I had several cases. 

March and April were unusually healthy, with the exception of a 
few cases of typho- malarial fever, which seemed, however, to yield 
more readily to treatment than those cases which occurred during the 
fall and winter months. 

A few sporadic cases of diphtheria have occurred through April and 
May, but none have proved fatal thus far. 

• n. 

During the month of December, 1S74, and January, February, 
March and April, 1875, diphtheria raged to an alarming extent in this 
valley. The disease was uncomplicated diphtheria, and proved fatal, 
sometimes by the accession of croup consequent upon the extension of 
the disease into the larynx and trachea ; at others by exhaustion. 

The first case occurred in a family of five, living in a large tenement, 
all of whom had the disease. Unfortunately for our town, the case 
was not treated correctly at the start. It falling into the hands of a 
Homeopathist, who treated it for teething, and then for worms, neither 
of which plans succeeding, the parent brought the child to my office 
in a dying condition, death occurring thirty hours afterwards. 

The family being Irish, the usual '^ wake" was held, although three 
other cases were found to exist at the same time, and in three days 
afterward twenty-eight cases were found in families who had sent 


delegates to the " wake." From this time until about the middle of 
April there were new cases occurring almost daily. One case of more 
than usual interest occurred, of which it will be well to speak. Mrs. 
W. expected to be confined about March 15th ; was taken quite ill 
Feb'y 8th with what seemed to be diphtheria, sore throat, fever, loss 
of appetite, restlessness and considerable nausea and pain in the back. 

Feb'y 9th, no better ; all the symptoms worse. 

Feb'y 10th, about the same, symptoms of labor coming on, which in 
fact proved to be so, as she was delivered of a very delicate male 
child at lOi P. M. 

Feb'y 11th, very much worse, the glandular swelling great, intense 
fever and delirium, tenderness over the abdomen, but no tympanites ; 
lochial discharge very offensive and scanty ; pulse 150 ; temperature 
108^; respiration 50 per minute; throat slightly coated with dark 
grayish patches. 

Feb'y 12th, ^i A. M., surface of the body covered with a fine scar- 
let rash ; tongue had cleaned during the night, which left it looking 
like a ripe strawberry; temperature 108; pulse and respiration same 
as day previous ; delirium ; abdomen swollen and tender ; urine scanty 
and highly absumious. 

Feb'y 1 3th, had a severe chill at 3 A. M. ; lasted one hour ; reaction 
very severe ; six hours afterward the temperature 108 4-5, being the 
highest point my thermometer ever reached when tried on any patient. 

Feb'y 14th, respiration 60 ; pulse IGO ; temperature 108 ; head symp- 
toms not quite as severe ; abdomen greatly swollen and tender to the 
touch ; lochial discharge scanty and offensive ; itching of the surface 
unendurable ; cuticle had commenced to peel off the fingers and fore- 
arms ; very restless. 

Feb'y 15th, temperature 107 ; pulse 140 ; respiration 40 ; bead clear ; 
diarrhoea through the night and very restless ; urine scanty and highly 
absumious ; abdomen still tender. 

Feb'y 16th, temperature 106; pulse 130; respiration 30; abdomen 
not quite as tender, but very much swollen ; lochial discharge quite 
profuse and not as offensive. From this date until Feb'y 27th, there 
was a gradual abatement of all the symptoms, when the temperature 
was 99 ; respiration 22 ; pulse 100, and the kidneys acting very much 
better ; urine albuminous ; the throat, of which I have said nothing, 
remained very much swollen, and patches of a dull grayish hue would 
appear and disappear about every third day, and up to the 27th ult. 


the tonsils and posterior nares dark and engorged ; bled when 
touched ; tongue yery red and tender ; from all of which she has, 
however, fully recovered, this 24th day of April, 1875. 

A few words as to the treatment of this case, which consisted of 
sponging the whole surface of the body with cold water, as it came 
from the pump, every second or third hour, after which she would 
express herself as very much better, and drop off into a short doze. 
Opium, one grain every fourth or eighth hour; Quinine, gr. iii 
every sixth hour, for the first eight days, afterward in tonic doses ; 
Hyposulphite Soda, grains l-6th every second hour, comprised the 
treatment, except champagne and beef tea. 

This was the only case out of 135 cases of diphtheria which occurred 
in my practice within a period of five months, that looked at all as if 
the diphtheritic character had been engrafted, so to speak, on to scar- 
let fever, and does look, and has led to the supposition, that these 
diseases are essentially the same, or, in other words, that diphtheria is 
a modified form of scarlet fever, unaccompanied by the scarlet rash. 
The case in question had suffered several years previously from diph- 
theria, but never from scarlet fever. It is an acknowledged fact that 
persons who have suffered from scarlet fever eujoy a comparative im- 
munity from future attacks of that disease, or, if an exceptional case 
does occur, it runs a very mild course. Therefore, these two circum- 
stances appear to contradict the belief that diphtheria and scarlet 
fever are essentially identical, so that if they proceeded from the same 
cause, we should naturally expect that persons who had undergone 
one form of the disease would be exempt from the other, or that at 
least the operation of the poison would be modified, as is usually seen 
to be the case in second attacks of scarlet fever and the other eruptive 
diseases. But this is not the case ; diphtheria frequently attacks the 
same person a second and even a third time within a few months, and 
the subsequent seizures, instead of being more mild, have sometimes 
proved more severe than the first, for I have cases on record which, to 
my mind, fully illustrate the non-identity of the two diseases. 

In treating diphtheria I relied principally upon chlorine in various 
forms, stimulants and quinine internally, together with chlorinated 
or carbolated injections into the nostrils, from the use of which I 
have witnessed the happiest effects. I have frequently seen children 
of 8 and 4 years industriously trying to use the syringe which had 
been provided for the purpose, as it " made them feel so good." 


Whether there is a nest of the Bactivia diphtheriticas existing in 
the posterior nares or not, during the invasion of the disease I invaria- 
bly find when that cavity is kept free from the fetid collection which 
exists in almost every case, that the patient, let it be child or adult, 
will rest better, from the simple fact that they can breathe free and 
unobstructedly, and not bo obliged to keep constantly swallowing 
immense quantities of poison into the stomach, where nothing short 
of decomposition can be the result, whereby the septic poison is 
rapidly distributed throughout the system, poisoning the nerve-centres 
and causing death from inanition and failure of the heart's action, for 
I have witnessed cases of death from the disease when I am certain the 
heart's action had ceased from 1 to 2^^ minutes before the subject stop- 
ped breathing. 

A few words as to topical applications. With the very worst cases 
I used nothing stronger than the following : 

T. Ferri. Mur. jiv. 
Acid. Mur. Dil. ^i. 
Aqua Pur. ^ii. 

M. Sig. 20 drops every third hour, with water ; also apply to the 
tonsils with brush three or four times per day. 

The dose named is for an adult. Here we have an abundance of 
chlorine, and those that were old enough to give an opinion, express 
much gratitude afcer each application. 

Those who were never treated with tannin, sulphuric acid, ice, and 
many other quite reliable agents, did not get along nearly so com- 
fortably, and, in fact, did not get along well until I placed them on 
this treatment, assisted, of course, by the nasal injection. 

Of stimulants I cannot say too much in their favor, especially 
brandy and champagne with ice. To one case of the many I only 
will allude. Willie N., aged 10 years, had been complaining twenty- 
two hours ; glandular swelling very great ; tonsils and palate a dull 
claret color, studded with dull grayish patches ; a profuse offensive 
nasal discharge ; pale and dejected countenance; diflSculty of breath- 
ing and swallowing; pulse 150; temperature 105. I immediately 
commenced the use of the nasal wash, with champagne and beef tea ; 
small doses of Liq. Opi. Co. occasionally. Thi& lad took within the 
ensuing eight hours one quart of the wine, with the effect of reducing 
his pulse to 110, and temperature 102, and a good deal better state of 
the whole system ; same treatment was continued, with the addition 


of the iron and acid mixture, and less pr more of the wine, as occa- 
sion or the urgency of symptoms demanded. He made a complete 
recovery at the end of the fourth week. 

Nasal hemorrhage occurred in over one-half the cases to a greater 
or less extent, which could only be controlled in some by the injection 
of a few drops of Ferri. Persulph. into the nostril by means of a hypo- 
dermic syringe. 

But it is not my intention to theorize upon this subject, but to 
give in as few words as possible, the result of my experience and 
observation during this one epidemic of Diphtheria. 

Of the 135 cases to which I prescribed, 18 proved fatal, 13 from 
exhaustion and 5 by the accession of croup. Nine deaths occurred 
before medical aid could reach their houses ; these were among the 
very first that occurred. 


Abscess of the Larynx, Simulating Croup. 

The Larynx in children is subject to several acute diseases, which, 
although pathologically distinct, are yet so alike in their symptoms, 
that the diagnosis can at times be determined only by a post-mortem 
examination. There is no class of cases, moreover, wherein the matter 
of treatment, the power of accurate diagnosis is more desirable or can 
be of greater importance. It is not my intention to enter upon the 
consideration of those cases where the mucus membrane is the subject 
of morbid action. There is another class of cases which present the 
same laryngeal obstruction, which prove as fatal, and which from their 
greater variety are extremely Uable to be mistaken for the former, but 
which differ entirely from them, in fact that the morbid action is extra 
laryngeal. In making my research into the history of this affection as 
referred to by Drs. Abercrombie, Fleming, Boaki, and Allen of New 
York, the more important diagnostic points are the following : 

1st The affection is more gradual in its onset, and does not endan- 
ger life so rapidly as croup. 

2d. Difficulty in swallowing is in most cases a prominent symptom, 
and any attempt at deglutition at once induces a paroxysm of 

8d. In abscess, change of posture, and especially the horizontal 
position, aggravates the dyspnoaa, and, like the act of deglutition, is 
apt to induce a paroxysm of suffocation. 


4th. The cough is low an^ hoarse, and has Dot the clanging brassy 
sound of the early stage of croup. These characters, taken together 
with the history of the case, should be sufficient to place one on his 
guard for extra-laryngeal disease. 

Ga»e I. Mrs. E., a weakly, delicate female, aged 36 years, I found 
suffering from difficulty of breathing, which had been gradually in- 
creasing for eight days. Concluding that the disease could not be 
croup, I was led to particularly examine the throat. She had a clang- 
ing cough, coming on in fits; the face was dusky; lips blue; the 
pulse feeble and quick. It could not be ascertained that there was 
any pain in the region of the larynx, but upon looking into the back 
of the throat, it was seen to be somewhat congested and looked full. 
Deglutition is difficult and brings on cough and dyspnoea ; externally, 
the throat looks full on each side. Had a consulting physician, who 
said she had dyspepsia, and I had better give her Carbonate Ammonia. 
Two days afterward I noticed she sat uprightly and could not swal- 
low at all. Upon examining the larynx, thought I saw a slight fullness, 
and rather inclined to point posteriorly; concluded it was an abscess, 
and passed a needle into it, whereupon I found it contained pus. I 
passed a bistoury into the abscess and evacuated about four table- 
spoonfuls of thin pus of a very offensive odor, attended with the 
immediate relief of all the distressing symptoms. The lady made a 
slow but perfect recovery, the cavity continuing to discharge for about 
six weeks. 

Case II. A weakly child, aged 8 months, was brought to my house, 
suffering from glandular swelling under the lower jaw, left side. No 
cause for the swelling could b3 detected, and the mother was advised 
to bathe the child with warm water and apply warm flax-seed poul- 
tices. One week after I was sent for to see the child. I found her 
suffering from difficulty of breathing, which she had been suffering 
from for about two days. Respiration was accompanied by a loud 
stridulous sound, audible throughout the room, which, with the 
accompanying dyspnoea, was at once suggestive of croup. There was 
a hoarse cough without clangor. The throat was examined but looked 
quite healthy. Upon examining the glandular swelling it had entirely 
disappeared ; but there appeared a fullness, but no hardness in the 
lower part of the neck, especially during respiration, and the trachea 
seemed to be pushed slightly out of the mesial line toward the right. 
This fact, with the history of the case, and the revolution of the other 


case, led me to Buspect that I had again to deal with extra laryngeal, 
affection. Spts. Am. Aro. and warm ponltices were ordered. Condi- 
tion of the child remained the same for about a week, (the idea of 
croup was of course negatived), at the end of which time I determined 
to explore with needle, but failed to find anything. The poulticing 
was continued with stimulants and nutrition freely given. At the end 
of the third week I at last could feel a small rounded swelling about 
the level of the isthmuth of the thyroid and at the outer margin of the 
sterno-hyoid muscle. Pushing in a bistoury, fully three ounces of 
pus escaped. The cavity extended downward. Steady improve- 
ment in respiration resulted. The cavity healed in about four weeks. 
The child continued feeble for some time, but finally regained its 
health entire. In the Philadelphia Medical Times of June 14th, 1873, 
there are two cases recorded, and I have recently received word from 
Dr. Stephenson, of Edinburgh, Physician to the Royal Hospital for 
Sick Children, some very interesting cases indeed. 


The Action of Mercury. 

Recent experiments all tend to prove that mercury does not increase 
or improve the biliary secretion ; in fact, has no direct effect upon it. 
But so long as they are confined to healthy organs, they can never 
demonstrate that it has no pathological action which was interfering 
with the performance of function. It is solely upon observations 
made in disease, that such questions can be determined. 

To argue from physiological experiments alone, even when sup- 
ported by the spectacle of a constitution shattered by mercury, is 
to act the play of Hamlet,' with left Hamlet out. At the same time, 
the value of these experiments in discussing this question is great. 
They have been conducted with so much care and skill, and the 
results have been so very uniform and correctly decided, that any 
proof of a cholagogue action on the biliary secretion, must be very 
decided indeed, to shake their result ; while we must be ever on our 
guard, least we are led away by old ideas ; remembering als'^ 
mere relief of symptoms does not necessarily prove a r 
effect of the remedy. 

The effects of mercury are often appealed to in t^ 
rangements of children, to support its cholagop 


question will therefore come to be discussed ; bat the subject of how 
and in what cases mercury should be employed, cannot be determined 
by a discussion of its effects upon the liver only ; the whole subject of 
its action upon the economy must be embraced, if we are to arrive at any 
conclusion as to its use even in biliary derangements. The stomach, 
liver and bowels are not functionally independent organs, but bound 
up in the closest sympathetic relation with each other and the 
economy at large. Derangement of A may produce perverted action 
of B, and a remedy acting solely on A may be thus made to have a 
good effect upon B, or vice versa. Some of the intestinal derange- 
ments of children afford an excellent example of this. In a recent 
paper read before the Medico- Chirurgical Society of Edinburgh, by 
my friend. Dr. Stephenson, it was shown that in cases where both 
liver and stomach have been deranged, in many of which the liver 
seemed specially at fault, and where there was no indication of want 
of power in the stomach, an absolute return to the healthy state 
was produced, not by mercury, but by pepsine, which could only act 
upon the stomachic digestiou. This example Is very valuable, because 
both the action of the remedy and the results are clearly defined, and 
warn us that in judging of the action of a drug, we must not sim- 
ply limit ourselves to its physiological action on organs we want to 

There is a very prevalent, I may say, a universal idea, or error, with 
regard to the action of mercury on children ; it is, that they are less 
susceptible to its constitutional action than adults. This has arisen 
and is solely based on the fact that young children are rarely if ever 
salivated, while all other physiological effects are ignored. My opin- 
ion is, that in young children the constitutional effects, if any, are 
more readily produced, and that injurious results are more rapidly 
brought about. We have not salivation as a guide, but take another 
index, one that can be readily observed. In syphilitic eruptions in 
children, I have frequently seen very decided results in six days, from 
the use of a grain of gray powder night and morniug. Here there is 
an effect from less than twelve grains. It is a therapeutic action, 
no doubt, and one therefore which may be evinced before physiolog- 
ical effects, but yet indicates that the constitution has been brought 
under its influence. A smaller amount, however, if otherwise given, 
will produce very perp«nf.r> r influence on the economy. The first 
of tbA inrbid ""1 ^ ■* >n - lays Dr. Clark, is a state of pallor. 


feebleness, sickness and frctfalness, with green mncns eyacnations. 
These symptoms are frequently referred to as the infants* malady, real 
or supposed. They are in fact, the nsual, the natural effect of the 
drug. Dr. Lewis Smith remarks, calomel when administered daily, 
has a very depressing effect ; and Dr. West, referring to its employment 
as an alteratiyo and laxative says, "there is no doubt but that used 
with either of these objects, it is a remedy of great value, and the 
objection to its employment is not that it fails to procure the desired 
end, but that it answers them at a greater expense to the constitutional 
power than was necessary." 

Other remedies exert an alterative action over the secretions, with- 
out that depressing and irritative iufluence which attends the use 
of mercurials ; much of the depressing influence may be avoided by 
a careful administration, and other effects are to be looked for in 
determining its action. The most important of these is the produc- 
tion of anemia. 

The most extreme case of this kind was that of a child at the hos- 
pital for sick children, when for some indefinite reason, the medical 
attendant had prescribed one dozen powders of gray powder, contain- 
ing one grain each ; these were all administered, but as the child waa 
still ailing, they were repeated by the parents, without consulting the 
doctor ; and a third dozen had been got, but not given, when the 
child was seen. I have since then watched the effect on other child- 
dren, and now regard anemia as a most important symptom to be 
watched for in the administration of hyr'g for constitutional affections 
of children. If then we take the depressing influence of mercury, and 
the production of anemia, and not salivation, as our tests for the 
physiological action, we may aflirm that children are just as suscepti- 
ble to its action as adults, if not more so. So much as to its baneful 
effects. I turn now to its employment in intestinal derangements, and 
select one of the least complicated class of cases, viz : where an 
otherwise healthy child is suffering from constipation, and is passing 
white, chalky motions, all are agreed that such a condition is the 
result of imperfect digestion and the absence of bile in the intestines. 
I have treated sncli with mercury alone. The results have been 
■ometlmos no change in the character of the motions, but considerable, 
griping and pain. When further action occurs, the bowels are more 
freely moved, softer in character, and mixed with green. Finally, the 
appearance is entirely changed, and the mercurial motions are obtained. 


which continue for some days. Stopping the remedy in the favorable 
cases, a return of the evacuations takes place, but very gradually and 
seldom without some other remedial agency; while in the unfavor- 
able, the old chalky stools again appear. To others, I leave to 
explain as they like, the nature and cause of the green evacuations. 
Whether from the coercion of some tardy flowing bile from the gall 
bladder or not, certainly, when we consider the result of the explana- 
tions, and of the successful cases, the frequent failures, and necessity for 
other remedial agents to establish a cure, there is really no evidence 
of any special action in such cases on the function of the liver, which 
can in any way controvert the results of the physiological experi- 
ments. A dose of castor oil, and regulation of the diet, will in many 
cases suffice to bring about a more speedy result than can be obtained 
from the use of the hyr*g alone. When compared with other reme- 
dies which have a supposed action on the liver, as rheum and phos. 
soda, its action is far from satisfactory. Its cathartic action alone, 
by unloading the bowels and freeing the circulation, is quite sufficient 
to explain the results. 

Jaundice in children might also be referred to, but it is unnecessary 
to discuss in detail, as it is an affection which yields to the very 
simplest treatment, and entirely without mercury. There is another 
class of cases which go against mercury very strongly ; it is when 
there is a diarrhea with copious white, watery evacuations without 
any indication of inflammatory action ; in these it is apt to produce 
its irritant action, changing the color to green, but without any 
improvement in the chikVs condition ; in fact, it is not the liver that is 
primarily at fault, and even did minute doses produce beneficial 
effec.ts, I should ascribe its effects to its action on some other organ. 

The employment of mercury, therefore, to my mind, must be based 
upon other reasons and for other ends than a direct action upon the 
biliary secretion. To best determine what these are, we must look to 
other actions than those we have mentioned. Although physiological 
experiments have not proved just how and in what way it operates, 
that is no reason why it may not be used after the manner of a 
rational empiricism. In obstinate and protracted retchings of a 
bilious attack, I have seen the vomiting arrested by a few grains of 
calomel in sugar, laid on the tongue and swallowed, when other 
remedies had failed, being at once rejected; also in cases of vomiting 
with robust children where it is protracted, the bowels confined and 


no tendency to irritable mucus surface. This seems to be a sedative 
action, but must not be taken as identical with that spoken of by 
some writers, where it is given in small and repeated doses. Yogel 
remarks in dyspepsia caused by abnormal irritation of nutrients, the 
child is to be kept upon strict diet for some days, nothing but muci- 
laginous broths, <&;c. ; and then goes on to say, ^' calomel in one-eighth 
gr. doses, given two or three times daily, exercises an extremely 
beneficial effect upon such an irritable mucus membrane ; it produces 
a few green evacuations, the tympanitic abdomen becomes smaller 
and softer, rest and sleep follow, and the child begins to digest 
again.'* This is one of the errors medical men fall into ; the diet is 
regulated, the cause of the ailment in all probability removed, but the 
credit is given to the drug. It is certainly surprising to find Vogel 
making such a statement, when on the previous page he clearly states 
that ^^ the whole basis of treatment depends upon strict diet, or the 
deprivation of food, as rest in general, and of the diseased organs in 
particular, forms the first principles of therapeutics.'' The irritable 
condition for which calomel is given needs more accurate description 
than merely dependent upon " abnormal irritation of the nutrients." 
As I have never prescribed it in such cases, or in any other form of 
irritable mucus membrane, I simply question its utility, and ask for 
greater accuracy in description regarding the cases where it is of 
service. Combined with opium it is often given in inflammatory 
affections of the bowels, but the good effects may so justly be referred 
to the opium alone, that I shall not enter upon this method of its 
administration. As an aperient in habitual constipation, there is no 
defence for calomel ; but as a purge given once or twice, with some 
definite reason for its use, there can be no objection. In times past 
its supposed action on the liver seemed a rational explanation of its 
use, and, although we are now told this is a delusion and a snare, 
experience is in no way affected thereby, and mercury may still be 
employed to the decided advantage of our patients. In infantile 
syphilis, I have the greatest confidence in it ; cases do recover under 
other treatment, but it does not follow that all would equally do so, 
nor is it certain that the cases so treated have recovered so rapidly. 
Whilst I would greatly limit the use of the medicine in intestinal 
affections, I believe that the outcry against it has caused us to overlook 
some of its beneficial effects when addressed to the constitution in 
general, and have become too timid in its employment where it is not 


only perfectly safe, but possessed of greater power than any other 
article in the pharmacopeia. Dr. Hellyer, speaking of it in connec- 
tion with diphtheria in children, says, ^^some of the worst cases 
in which recovery has occurred, calomel has been the remedy ; it is 
not a drug to use indiscriminately in all cases, but only to children of 
moderately good constitution, and to cases in which the exudation is 
firm and thick, or causing laryngeal obstructions with sthenic symp- 
toms. Experience shows me that where I have signally failed to 
produced change in some morbid action by the use of the iodide 
potassium or other preparations of potash, I have succeeded with the 
use of mercury. 

Case \Bt. A lad had some thickening of the head of the tibia, 
with effusion into the head of the knee joint ; a previous attendant 
had administered acet. pot. and blisters to the part. I gave iodide 
pot., renewed the blisters, bandaged the knee carefully, and enjoined 
absolute rest, but with no improvement. The patient was not stru- 
mous or rheumatic, but by carefully sifling the family history, I got 
sufficient evidence to assure me that he might be syphilitic. I gave 
gray powders, and in a very short time the lad was walking about, 
and the thickening very much diminished. 

Com 2d, A girl with an eruption resembling psoriasis, but the 
scales were found to be readily separable from the skin, very much 
like a crust; underneath there was a moist red surface, but without 
ulceration. She had been treated with iod. pot. and arsenic, but no 
effect ; she was then given bichloride hyr*g, which was soon followed 
by a steady and rapid improvement. " No evidence of syphilis in 
this case.'' 

The opinion with regard to the action of mercury in such cases is 
that the good effects are obtained not by its " operating on the blood," 
but by a direct effect on the cell element of the tissues themselves, 
stimulating their action in the various transformations through which 
they normally pass ; that it has such an influence, can readily be 
observed by the eye, when employed in the treatment of condyloma, 
chronic impetigo, ulcers and the like. This is the first action of the 
remedy, which, if carried further, may pass the physiological line to 
the pathological, producing proliferation of the cell elements, and 
degeneration of the ultimate products. 

It is to the first action alone that its use should be limited, and thus 
employed. I regard it in power as second to none in the pharma- 


copeia. Its use. however, as such, should be as the spur or whip to 
stimulate, not to punish, to be given for a short time only, to be 
renewed occasionally if necessary, not to be continued throughout the 
whole course of the disease. To obtain its good effects, however, and 
to run no risk of harm, it must not be used indiscriminately. The 
state of the constitution must be considered ; no marked cachexia 
must be present ; the nutritive power of the tissues in general must 
not have been lowered by previous disease, they must still have re- 
tained their natural tendency to normal nutritive changes, otherwise 
the stimulus of the mercury may hasten the degenerative process. To 
note the character of the constitution, in making our observations, is 
too much neglected. It ought always to be a point of careful consid- 
ation ; and my opinion, so far as mercury is concerned, is, that it 
manifests its good effects in the sluggish constitutions of the strumous 
and syphilitic diatheses, much more than in the active cellular trans- 
formation of the tubercular class, in which its depressing and 
irritating effects are much more readily produced. 

In fact, it is in the constitutions which are most liable to those exter- 
nal affections where mercury is of service, that we are most likely to find 
internal morbid processes which are amenable to the internal use of 
medicine. Thus far and no further, would I theorize ; not that its 
action is thereby explained, but a distinct line drawn, for our guid- 
ance in its use. From the above, then, let us draw the following 
conclusions : 

1st. That mercury may be used to influence the constitution with 
perfect safety, and without any injurious effects upon the general 

2d. That to obtain its therapeutic action, it is not neces^ry to 
produce its visible physiological effects, and that it becomes injurious 
as soon as these are manifested. 

3d. That in children its injurious effects are as readily produced 
as in adults, if not more so ; and that such must be looked for, not by 
its action on the mouth, but in its depressing influence and deteriora- 
tion of the blood. 

4th. That it should be used only so far, and with the object of 
stimulating the nutrition changes of the tissues, not the character of 
constituents of the blood ; and that as such it should be used as a 
whip or spur only, that is, occasionally, and at intervals, not contin- 


5th. That its use in modifying acute inflammatory action is very 
limited, and requires further observation; but that there is no question 
as to its power over the products of inflammation, in starting the 
process of resolution and absorx)tion where these have been arrested. 

6th. That no number of cases improperly treated with mercury, 
no number of constitutions shattered by its abuses, no number of 
instances where cases have been cured without it, can in anyway 
invalidate the results of its effects when it has cured when other 
remedies have failed, or lessen in any measure the position which I 
here defend, of a jadicious use of the medicine. 

It remains for me only to refer to the method of using mercury in 
the affection of syphilis in children, for my opinion is that its power 
over the diseased nutrition cannot be dispensed with, and is second 
to none, and I never care to treat a case entirely without it. It is to 
what extent should it be employed, that I would refer. Here you will 
find a difference from the general idea or mode of practice. What 
we can influence by mercury is not the syphilitic diathesis, but merely 
its pathological results. 

The former never can be eradicated; but when diseased action 
occurs, that can be modified, and mercury aids in the return of a 
healthy action, but that attained, the continued use will never eradi- 
cate the pathological tendencies, which are inherent in the character 
of the constitution. 

Mercury will cure the syphilitic diseases of the first year of life ; 
but no extent of its use at that time, will lessen the tendency in after 
years to interstitial keratitis, or any later manifestation of the taint. 
Its use, therefore, as I have before said, be the whip or spur, while we 
follow up its action by other and safer means. I do not, therefore, 
continue its use after every manifest action of syphilis has disap- 
peared, as recommended by *Diday, but stop whenever improvement 
is manifested, and change to soda et pot., iod. of iron, or cl. pot. which 
are most valuable remedies, but alone have not the same power as 
when combined with mercury. Under their use the symptoms may 
return^ but the spur can again be applied ; and in this way I have 
found that a fortnight^s use of one or two grains of gray powder 
daily, is sufficient at any one time, and the longest period I consider 
it safe to continue it without interruption, or even less dose if it 
proves irritating to the intestinal mucus membrane. 

Diday on eyphilis, page 262. 


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la answer to question 1st, founding my opinion upon my exper- 
ience with over a hundred cases of diphtheria, since last July, I am 
led to the conclusion that topical applications are of undoubted 
value in the treatment of that disease. I think, however, that the 
agents employed should be of a mild, soothing, and gentle astringent 
character; strong applications of argentum, the mineral acids, &c., 
being of a doubtful propriety, if not positively injurious. Granting 
the theory that diphtheria is a general and not a local disease, and so 
will* not yield to treatment until the system has been properly acted 
on, still, by keeping in check the extensive inflammation and conse- 
quent swelling that is apt to occur in the nasal passages, pharynx, 
&c., by means of local applications, we gain time for the effect of 
internal remedies and prevent that rapid prostration that is likely to 
take place from insufficient oxygen and consequent impurity of 
blood. Patients treated by me with external applications to throat, 
and without any appliance whatever, seemed to do equally well. 
Although a large number of deaths occurred in the district alluded 
to from malignant sore throat, I have been so fortunate as to lose but 
three cases. 

In regard to 2d query, although, perhaps, not using calomel in my 
practice as much as many medical gentlemen of the present period, 
the reason for which perhaps it would be difficult to find an explana- 
tion ; possibly, the force of example, or a desire to be fashionable, 
in discarding a good, old and reliable remedy for some new article of 
the journals, the virtues of which are ascribed to be magical, with 
which I desire to become acquainted ; but, to say but little, upon 
a subject upon which so much might be said, or upon the virtues of a 
remedy upon which so much has been written, in the language of Dr. 
Headland, " It is the very prince of that class of remedies, unfortu- 
nately too few, that are capable of entering the system, of grappling 
with a disease of the blood, and of coming off victorious in the strug- 
gle.'' I am accustomed to use it, and rely upon it, in all those morbid 
conditions requiring an efficient hepatic stimulant; in verminous 
affections of young children ; in some cases of cholera infantum, com- 
bined with chalk and opium ; in primary syphilis, in which I regard 
it as the ^' sheet anchor of hope." I have, on occasions, allayed ob- 



stinate yomiting, when no other agent eeemed to be effectual ; and I 
may say, in conclusion, that I regard it as a remedy that has giyen me 
satisfaction in yery many morbid conditions. 
TncKEBTON, April 26th, 1876. 

Communication by Dr. A. Elwell. 

I use ice in malignant scarlet feyer, both internally and externally ; 
also tr. ferri. mur., and sometimes paint the fauces with oil capsici. 
In diphtheria I use frequently a solution of sulph. hydrastin, applied 
with camel-hair pencil ; sulph. zinc, as a gargle ; potass, chlorat. on 
the tongue dry, coming in contact with the fauces in the act of deglu- 
tition. In the use of calomel, I rely on it in diseases such as pneu- 
monia, catarrhal feyer, pleurisy, &c. ; some diseases of the eye ; 
syphilis ; gonorrhoea in its acute stage ; also, in some diseases of the 
brain, spinal chord and their coyerings. 

During the summer we had a great many cases of cholera infantum 
and diarrhoea of children, and some few cases of dysentery. Inter- 
mittent feyer we had in great abundance, so much so, had there been 
no other diseases to treat, we would haye been kept busy with that 
alone. Most all the children sick with* other diseases gaye eyidence 
of intermittent tendencies. During the winter hooping-cough has * 
been yery preyalent in our yicinity, and when not complicated with 
pneumonia or catarrh, gaye us but little trouble ; but in many cases 
this complication existed, and then it required our best efforts to get 
our little patients safely through. This spring has brought with it 
many cases of pneumonia, many of a typhoid character. 

Noyembcr 27th, 1875, 1 was called to Walter Norcross, 23 years of 
age; had been suffering from tape- worm for about one year; has 
seen about eighty-fiye feet of it. But to the case : I found him in 
conyulsions, and between o'clock P. M. and 10 A. M. the next day, 
he had had thirty-three conyulsions; took about §yi. blood from the 
arm ; gaye him bromid. potass, grs. xx. ; and tr. yirid. gtt. iy. eyery 
three hours. I had forgotten to mention that he was dropsical 
generally. I gaye calomel, squills and digitalis. In about three 
weeks ho walked out, and was apparently as well as eyer. 

March 25th was called to him again ; found him much the same as 
before, and in about the same length of time he had thirty-one con- 
yulsions ; treated him as before, and on the fifth day of his illness 


discoyered on his face, scalp, chest, front and back, an eraption re- 
sembling very much varioloid. As there was small-pox in our vicinity 
at the time, I cautioned them, at the same time telling them that this 
eruption might possibly be occasioned by the bromide. Our County 
Medical Society met at Mt. Holly about that time, and I gave the 
members present a synopsis of the case and treatment, and asked the 
question, Will Bromid. Potass, produce such an eruption ? Dr. Jos. 
Parrish, of Burlington, said it would ; he had seen many cases of it in 
the institution over which he had lately had charge. No other mem- 
ber had seen such results from its use. My patient is again apparently 
ViNCKNTOWN, N. J., April 24th, 1876. 

Poisoning by Oil of Tansy. 


On the morning of the 21st of February, at lOJ o'clock, I was 
called in haste to see a lady by her husband who informed me that 
when he went home he found her lying on the floor in the sitting- 
room, unconscious ; he took her up and laid her on a lounge near by 
I answered the call immediately, and learned the following : 

Mrs. G., aged 24 years, mother of three healthy children, the 
youngest fifteen months old and nursing, had experienced for several 
days past symptoms of approaching catamenia ; she related the same 
to a lady friend, who advised her to take a faw drops of the oil of 
tansy to assist nature in starting the secretion, which she concluded 
to do, as she had on two previous occasions taken about a quarter of 
a teaspoonful of the oil at each dose ; and, accordingly, at 7^ o'clock 
on the morning in question, she poured into a small wine-glass three 
tea^pooTisfuL of the oil of tanst/^ and swallowed it at one dose. After 
taking this heroic dose, which was half an hour after breakfast, in less 
than ten minutes she became so giddy and so cold and numb that 
she took to the lounge, and does not remember anything until about 
ten minutes after I reached the house. No one was in the house at 
the time excepting the three little children. Remaining in this con- 
dition for three hours, there is no doubt but what she had several 
convulsions ; how many no one knows, and in one of them had rolled 
off on the floor, where she was found as already stated. I found her 


in a comatose condition, head hot, extremities cool, respiration some- 
what difficult, pulse about 95 per minute and irregular, face swollen, 
pupils somewhat dilated. I directed warm applications to the feet 
and extremities, and applied cold water freely and vigorously to the 
head and face, when, in the coarse of ten minutes, she regained con- 
sciousness sufficiently to swallow. I then gave her large draughts of 
warm water, as much as I could get her to swallow, and in less than 
five minutes it produced copious emesis. In the course of a few 
minutes I repeated the draught of warm water, and it had the same 
effect as before, rendering her quite sensible. I then ordered a cup of 
strong coffee, which she rejected in about fifteen minutes. After 
awaiting about fifteen minutes longer I gave her the second cup of 
coffee, and this she retained. The extremities had now become quite 
warm, the breathing more free and natural. She complained of 
pain in the head and seemed quite nervous. I now ordered her 
bromide of potassa with elix. valerianate of ammonia, with a view of 
diminishing the pain and to quiet her nervous system ; then left, re- 
turning in about six hours, when I found her more comfortable, pain 
in head not so severe, and was not so nervous, skin moist and warm ; 
ordered her to have warm gruels or broths, little and often. Saw her 
the next morning at 9 o'clock and found her much improved, although 
complains of dizziness when she attempts to sit up ; pulse 80 per 
minute ; pupils nearly normal ; breathing freely ; does not complain 
of any pain or burning sensation in the stomach. She continued 
gradually to improve and made a good recovery from the severe ill- 
ness, with the exception of impaired vision of the left eye. Mrs. G. 
had previously enjoyed good health, and, owing to this fact, and 
swallowing the dose so soon after taking a moderately hearty meal, 
might to some extent prevented it from proving fatal. I might men- 
tion here that when I entered the room on the first morning of her 
illness, I could readily detect the odor of tansy, but much more so 
after vomiting. She tells me that she urinated very freely and often 
for several days after the beginning of her sickness, and could detect 
the odor of tansy in the urine for one week after. 

I report this case as one of interest, from the fact of a recovery 
from so large a dose, as a case has been reported where a girl had 
taken a teaspoonful of the oil of tansy in mistake, and died in one 
hour after. 

Mt. Holly, N. J., April 25th, 1876. 

reports of district societies, 181 

Communication by N. Newlin Stokes, M. D. 

I have learned to rely upon topical remedies in malignant sore 
throat of scarlet fever and diphtheria, as valuable aids in the treatment 
of these diseases. I generally use carbolic acid and glycerine, about 
twenty drops of the acid to the ounce of glycerine, and apply twice a 
day, first cleansing the throat as well as possible with cold water. 
The antiseptic powers of carbolic acid are great, and several appar- 
ently desperate cases have terminated favorably with this application. 
I use calomel as an indispensable agent in almost all inflammatory 
attacks that will not yield to opium alone ; in biliousness (so called), 
in many skin diseases, both externally and internally, and to allay 
vomiting in cholera infantum, &c. While this remedy requires care 
in its administration, yet I have no sympathy with doctors who pro- 
fess not to give calomel, and believe such to be dishonest in their 
assertions, or unsuccessful in their treatment. It may be too much to 
say that I would give calomel in all inflammations, such as anginose 
affections, &c., but in the majority of them, in alteratives doses, I am 
partial to its use. 

MooRESTOWN, 4th month 21st, 1876. 

Communication by Dr. Townsend. 

The past year has to us presented nothing of peculiar importance, 
except in some few individual cases, although we were kept comfort- 
ably busy most of the time. Topographically we are peculiarly 
situated, having really but half a practice in territory, the Delaware 
cutting us off on one side. Out from the river we seldom travel far 
enough to get out of the sandy soil into any alluvial upland or low- 
land deposits ; hence all of our patients, through the extent of our 
semi-circuit, are subject to the same topographical influences, except 

^ As to the amount of rain-fall or humidity, we are curiously influ- 
enced by our location. Storms coming from the west and northwest, 
are frequently diverted from their course, both by the river and 
Rancocus creek, which empties itself into the Delaware about three 
miles below Beverly ; so that frequently in summer we are suffering 
with drouth and dust, when our neighbors over the river, or below 
the creek, are having frequent rains. This causes quite a difference 


in the character and type of diseases prevailing in the different 
sections. Geologically considered, our locality presents no variety, 
except alternate and parallel belts of sand and gravel clay, ranniog 
from south-west to north-east until they strike the river. On the 
sand belts, wells runniug over twenty-six feet deep, strike marl and 
yield hard water; on gravel belts the water is soft at all depths. 
These variations of course influence not only diseases but remedies. 

We have had no epidemics the last year, except measles and hoop- 
ing cough. In the treatment of the last, when coming under our 
care, we have succeeded best with fld. ext. castanea, tr. belladonna 
and chloral. 

During the fall and winter, bilious remittent and intermittent 
fevers prevailed to some extent, with a few cases of typhoid of a low 
grade during the winter. During this spring, we have had a great 
number of cases of what seemed to be an epidemic catarrh, affecting 
the nose, throat, frontbl and maxillary sinuses, and extending in many 
instances to the eustachian tubes and ears, always attended by a severe 
spasmodic cough, and in many cases complete aphonia. A few only 
presented pneumonic symptoms. In all .the cases, the tonsils were 
swollen, uvula elongated, and the throat congested, but very seldom 

I have seen no cases of diphtheria, or anything resembling it, 
although our homeopathic men report a great number of cases, with 
miraculous cures. 

I have seen several severe cases of pleurisy within a few weeks, 
which yielded gracefully to verat. viride and warm applications. 

In the way of new remedies I have nothing to report, except to add 
to the authority of more experienced men in the recommendation of 
milk in typhoid fever, used ad libitum in all stages of the disease. 
This is hardly a new remedy, but rather a diet in my experience more 
important to the speedy convalescence and sound recovery of the 
patient, than the enormous quantities of beef essence and stimulants 
mostly given. The essence made from three pounds of beef, often 
given in twenty-four hours, is more than a healthy stomach ought to 
be expected to digest. 

In answer to the queries of Standing Committee, I would say first, 
that while having very little experience in malignant sore throat, I 
rely entirely upon local or topical remedies in all forms of ulcerated 
throat, together with the application of cold cloths externally. 



2d. While I use calomel in all cases of partial congestion, or irregular- 
ity of the liver, generally combined with blue mass, and podophyllin or 
aloes, I very seldom use it uncombined, and cannot say that I ever 
rely upon it any further than for its action upon the liver. 

Beveblt, April 23, 1876. 

Communication by Dr. E. E. Brown. 

Topical remedies in malignant sore throat are very useful, but I 
could not rely upon them exclusively. Salicylic acid in solution, as 
also the chlorate of potassa, with tinct. ferri. chlor. in solution, and 
used in the form of gargles, with tonics when indicated, and good 
nourishing food, has proved of more value in my hands than most 
other remedies ; but as we have to vary our remedies to suit the par- 
ticular conditions of the case, I do not adopt this course of treatment 
for every case. I believe calomel to be a valuable therapeutic agent in 
combination with other remedies in the treatment of some of the dis- 
eases of .the brain and liver, when an active purgative is required — in 
heart affections consequent upon rheumatism, and as a topical remedy 
in some obstinate skin diseases. 

During the months of July, August and September, I had a 
number of cases of typhoid fever of a somewhat peculiar nature. 
The course of the disease was more rapid than that of ordinary 
typhoid fever that I have noticed. The attack would commence very 
much the same as an ordinary intermittent, when in the course of four 
or five days, perhaps longer, it would assume that of a typhoid form, 
the emaciation being very rapid, and a tendency to diarrhea, with 
considerable tympanitis, and delirium; these symptoms would last 
with greater or less severity from three to five days longer, (there 
would not be constant delirium that length of time), and then would 
begin to convalesce, and in the course of two weeks from the begin- 
ning of the attack, although diebilitated, would be able to go out in 
the open air. 

The majority of my cases occurred in children over four years of 
age. The treatment consiste<d in the use of sulph. qninia in anti- 
periodic doses, liq. potass, citrat., with spts. ether nit. for the first few 
days ; and as soon as emaciation set in, vegetable tonics, milk punch, 
nourishing broths, <&c. Checking the diarrhea with astringents, chalk 


julep with tinct kino ; this treatment in most cases proved satisfac- 

These cases are confined principally to one locality on one of the 
streets in the south-eastern part of the town. I could not trace its 
Cause, unless it was the low meadows that were in the rear of this 
street, and which were at times overflowed by high tides, allowing the 
water to remain there a sufficient length of time to become stag- 

Mount Holly, N. J., April 24, 1876. 

Communication by Dr. Theophilus Price. 

1. The value of topical remedies in malignant sore throat ? 
(diphtheria of course.) 

Ans, 1 would hardly dare treat a severe case without. Formerly, 
I used strong solutions of nitrate of silver, and I am not convinced 
that I have found anything better ; but I now use weaker solutions, 
seldom exceeding 20 grs. to ounce whenever I use it ; but in later 
years I have used tr. ferri. chlor., i or i^ combined With honey or 
syrup. It tans and shrivels the pseudo-membrane, and apparently 
modifies the morbid action favorably. The objection to its use, is the 
disagreeable taste and supposed acid reaction on the teeth. 

The greatest drawback to the use of topical remedies, and apparent 
ttselessness of them, is, probably, owing to the failure of nurses and 
care-takers of the sick, to properly and skillfully apply them. If the 
practitioner could see that the membranes were touched every time, 
success would be greater. Of course, these suggestions only apply 
when the false membrane is in reach. 

I am old-fashioned enough to apply weak mustard plasters, or 
slightly irritating poultices to the throat, externally, to maintain 
moisture and irritation, but never to blister. 

I have used ice carefully in a few instances, but confess to a want 
of courage, to depend on it 

2. The morbid conditions in which I rely upon calomel as a 
therapeutic agent ? 

Ans, Almost none. L use it combined with opium, in bilious and 
mucus diarrheas, and in dysentery ; sometimes in hepatic affections ; 
seldom in fevers ; never as an antiphlogistic ; very seldom as a direct 
Alterative ; very seldom as a purgative. 


The past year h§8 been one of general health along the shore. No 
epidemic has invaded this section of Burlington county, except the 
recent visitatien of epidemic catarrh. At Bass River, however, six 
miles distant, a fearful scourge of diphtheria has prevailed during the 
greater part of the winter and spring. 

Dr. Reeves, the practitioner in that neighborhood, has treated, 
probably, 150 cases. It is estimated that 25 per cent, of the popula- 
tion of the infected district was affected with the disease, in a grea^r 
or less degree. The mortality probably reached 10 per cent, of those 
affected. It is remarkable that the complaint should have shown so 
much virulence, and remain confined to so small an area; all the 
cases having occurred within a territory not exceeding six miles 
square. I am not aware of any decided cases in Tuckerton. The 
population of the infected district will not exceed 800 persons. Dr. 
Beeves thinks that evidences of contagion are quite clear. 

An epidemic catarrh has been our only severe complaint during the 
winter ; exhibiting the usual symptoms ; running its usual course in 
two or three weeks ; but prone to relapse, and showing quite a 
tendency to laryngeal congestion. Croupy cough and dyspnoea, with 
pain in the larynx and trachea, were frequent symptoms in the 
earlier stages. 

Tuckerton, N. J., April 19, 1876. 


To Chairman of Standing Committee^ &c. : 

Tonr reporter from Camden county has not been 
able to gather as much material as he could have 
wished ; owing to the fact, that but one of the mem- 
bers of the Standing Committee has sent in any 
report, namely. Dr. Snowden of Waterford. There- 
fore the report must necessarily be implenary, and 
can not cover the whole of the county, as we could 
have desired. 

In the city of Camden, and vicinity, we have had 
during the past summer, and more especially in 


the month of August, more than the average amount 
of rain ; in fact, the meteorological reports of the 
United States show an unusual amount of rain-fall 
throughout the Middle and Eastern States, during the 
same period. Notwithstanding this, the reduction of 
the temperature was not so great as might have been 
expected from the frequent rains ; but we think that 
the exegesis lies in the fact, that the nebulae which 
encompassed the earth, offered a serious obstacle to 
the heat waves, from passing unopposed into the illim- 
itable space ; but reflected many back again to the 
earth, producing a condition of oppressiveness which 
was felt, very sensibly, by the aged and very young, 
and those who possessed enfeebled constitutions. 
Taking all conditions into consideration, we could 
not complain of any very severe endemics nor epidem- 
ics ; although, throughout the whole year, those two 
mortal enemies of the children, scarlatina and diph- 
theria prevailed, but not to an alarming extent, save 
and except in a few cases which put on a malignant 
type, and -marched on to a fatal conclusion, in spite of 
all medical agency. Some hooping cough pre- 
vailed in the early part of summer, and also a few 
cases of enteric fever, throughout the whole year : but 
nothing in their character worthy of special note. 

There was no great amount of intermittent nor 
remittent fever, owing, perhaps, to the rapid improve- 
ment in paving our streets, and filling up the low 
places ; and, with the exception of the rather unusual 
amount and threatening nature of diphtheria and 
scarlatina, the past season was not a very sick one. 

As autumn approached, diphtheria seemed to get the 
advantage of its companion, and presented, in many 
instances, quite a malignant character, although it 


generally yielded to early and energetic treatment ; 
yet in the city of Camden alone, there were about 
seventy deaths, making one to every Ave hundred and 
seventy-two — allowing our population to be 40,000 
inhabitants. The remedies which your reporter 
generally made use of in the last named disease, were 
internally, tr. of the chloride of iron, chlorate of 
potassium, quinine, wine-whey, milk-punch, egg-nog 
if necessary, &c. Topical remedies most relied upon, 
were iodine liniments and steaming with lime-water, 
every quarter or half hour ; this should be continued 
until the diphtheritic effusion has detached itself, and 
the respiration is decidedly improved ; when it may 
be gradually discontinued, but resumed again if there 
should appear the least symptoms of dyspnoea. The 
treatment above recommended has proven so satisfac- 
tory in the hands of your reporter that he believes it 
to be worthy of careful trial. 

My friend. Dr. Branin (of Blackwoodtown), informs 
me that he has uged in diphtheria, as a topical appli- 
cation to the throat, the solid stick of nitrate of 
silver, with the happiest effects. This, of course, may 
appear plausible, when we take into consideration the 
possibility of the disease being a local one in the 
beginning ; but, in a report like this, the pathological 
nature of disease cannot fairly be discussed. In 
respect to the treatment of scarlatina, we will only 
mention one topical application, that is, the steaming 
of the throat with lime-water, in all anginose cases, as 
the condition of the throat in this disease is very 
similar to that which occurs in diphtheria ; hence, 
what will benefit the one, will also benefit the other. 
In many of the cases of scarlatina, we had the common 
sequla, dropsy, following them, which generally yield- 


ed to the iodide of potassium and bromide of mercury; 
although in some cases it would not, but required other 
remedies more potent in their diuretic and diaphoretic 
properties. Recurring to the enteric or typhoid fever, 
we embrace this opportunitj^ of asserting that we have 
treated it according to the American system of prac- 
tice. As we have not, as yet, a sufficient amount of 
confidence to adopt the heroic plan of the German 
pathologists, which is in giving enormous quantities of 
quinine in an extremely short length of time, with a 
view of reducing the temperature of the body more 
rapidly, as they assert, than by any other mode of 
treatment ; if it can, by a successful competition with 
the American mode of treatment, prove itself superior, 
then we will gracefully bow and acknowledge its 

About the middle of February, variola made its 
advent into our city, in a locality wherein the typhoid 
fever was then prevailing, opposite to which a culvert 
emptied its noxious and organic contents on a large 
marsh. From this source, we believe, the " contagium 
virum," or the living disease germs, had their origin. 
All the cases of typhoid fever which your reporter 
met with, except two, were found here, and all the 
cases of variola which we had the misfortune to see, 
were also found here. Now we do not wish to be 
understood to say, that in this place was the origin of 
variola, but we do pretend to say that the close prox- 
imity of the place wherein these two diseases were 
first found by us, where these immense quantities of 
organic matter were deposited by the culvert, shows a 
close relation between putrefaction, fermentation and 
zymotic diseases. 

It will be understood that we do not presume to 


give the cause of any disease, for the real causes of 
phenomena escape us. In sound philosophy, the 
word cause should be reserved for the divine impulse 
which formed the universe. We can detect only 
correlations. One phenomenon succeeds another, and 
can not exist without its manifestation ; by abuse of 
language wef then say there is relation of cause and 

Whilst we are dwelling upon this phase of the 
question, we might as well notice the condition of our 
city. Now it is pretty well known to every observing 
mind, that it is not so favorably located as those cities 
which are on more elevated sites, hence its drainage 
must be more or less defective, and it is. Therefore, 
it is our opinion, that in a place so level as this, and 
all parts of it, being so little above the common water 
level, that the attempt to drain the immense quai^tities 
of organic matter which must necessarily accumulate 
constantly, by small culverts, many of which run 
nearly north and south for considerable distances, and 
not directly into the river, must necessarily prove a 
failure. It is also well known to every observing 
physician in Camden, that many if not all the cul- 
verts in the city, are partially filled with earth and 
organic matter which are never washed out at any 
time thoroughly by the rains ; therefore, they become 
.the source of infection, and the inlets which are con- 
structed for the ;gurpose of draining off the surplus 
water from the streets, become the foci of infection, 
and the frightful source of many if not most of our 
zymotic diseases ; and also the source of our water 
supply is poisoned by the drainage of six large cities, 
depositing tons of organic matter into a tidal stream 
which ebbs and flows to and fro and spreads its 



noxious contents on either shore and on the marshes, 
to become the matrix in which the germs of zymotic 
diseases are engendered. And strange to say at this 
enlightened day, it is from such a source that we are 
now drawing our water supply. Is it any wonder, 
then, (all things considered) that we have prevailing 
all the year round, zj^motic diseases ? • 

These truths are sufficiently apparent to all candid 
men, to create a feeling of surprise in every intelligent 
physician's mind, at the general apathy of the people 
toward things which so vitally concern their temporal 

In the language of *' the Builder,' we might prop- 
erly exclaim : 

*^ Our drains ! our drains ! our death-dealing drains I 
Choked up, with no outlet for rotten remains ; 
• Chronic hot-beds of typhoid, full of foul silt. 
Reflecting our ignorance, proving our guilt, 
And showing that we have been riding rough-shod 
O^er nature, and morals, and maxims of God. 
For pure air and water, in cities and plains. 
Spell health, if we keep right our dwellings and drains." 

During the winter which has passed, we encountered 
a few cases of asthenic pneumonia, which rapidly 
tended to a typhoid condition, and in which early 
stimulation was urgently demanded. No other pecu- 
liarity was discerned in their character. 

And now, owing to want of timf , we shall have to 
pass by the chronic diseases, as they take up much of 
our time in their description. 

In conclusion, we will give, as well as we can, an 
account of one very interesting special case. 

We were summoned on the third of January, 1876, 
to attend a Mrs. B., of the city of Camden, aged 


about 48 years. On first appearance we were led to 
believe that she was either pregnant or suffering from 
dropsy, but after more careful examination, we 
could distinctly feel a large, hard tumor above the 
pubis, and to the right of the abdomen. There was 
also a large quantity of fluid in the cavity of the 
peritoneum. » Carefully continuing the examination 
through the vagina, the tumor was found to be attached 
to the uterus. The uterine sound could be passed 
into the organ the ordinary distance, showing that 
the tumor was not intramural, but subperitoneal, and 
seemed attached to the right walls of the uterus. At 
that time the tumor appeared to be about 8 inches in 
diameter, very dense and round, and so situated as to 
make the removal of it by an operation very precari- 
ous and problematical. After having had two consulta- 
tions, one with Prof. Agnew, and the other with 
Goodell, both confirming the previous diagnosis — that 
the tumor was a subperitoneal fibroid, and could not 
be removed without in all probability proving fatal 
to the patient, no other course, then, was left to us, 
but to continue the medical treatment. Therefore, we 
decide to commence at once, with hypodermic injec • 
tions of some preparation of ergot, and in view of the 
painful and irritating effects of ergotine, we caused to 
be prepared a pure aqueous extract, which was used 
daily, hypodermically, without producing but very 
little local irritation and no abscesses at all. We have 
continued its use up to the present time, with marked 
effect upon the tumor, as it appears now to have been 
reduced at least one-quarter of its original size, but 
still not sufficient to prevent abdominal dropsy. 
Owing to the mechanical obstruction of the circulation 
of the blood, from the great size of the tumor, a pale 


straw colored fluid collects in the peritoneal cavity, 
very rich in albumen ; and to get rid of this fluid, 
which accumulates very rapidly, it becomes necessary 
to have frequent recourse to paracenticis abdominis. 
This operation has been performed ten times since the 
3d of January, 1876, and over two hundred pounds of 
fluid taken from the abdominal cavity. After each 
tapping, the patient feels very much relieved for about 
two, and sometimes three weeks, or more, when it 
becomes necessary again to perform the operation. 

Notwithstanding the immense quantity of albumen, 
which necessarily must have been drawn away in the 
several tappings, there has not been so much emacia- 
tion as naturally might have been supposed, and the 
patient is able to be around the house, and attend to 
some trifling domestic duties, and, perhaps, may live 
for many years. 

J. M. RIDGE, Reporter, 
Cahdbn, May, 1876. 

Theories of Fermei^tatioi^. 

Liebig and hU followers maintained that the agents which pro- 
duced fermentation were certain decomposing albaminoid snbstances. 
That when these were placed in a fermentable floid, by the motion of 
their atoms daring decomposition, they excited a movement of decom- 
position among the atoms of the fermentable material, thereby occa- 
sioning the splitting up of its molecules, and the formation of new 
compounds. During this process, the ferment neither took anything 
from the material, nor added anything to it ; the decomposition being 
effected solely by the. atomic motion of the particles of the ferment 
Certain microscopic organisms which had frequently been observed in 
fermenting fluids were held to be only incidentally present, the pro- 
cess taking place quite as well without them. Thus, by this theory, 
fermentation was a correlative of death, being an oxidation or decay. 

Pasteur, on the other hand, holds that the phenomena of fermenta- 
tion are correlative with life ; every process of fermentation (properly 


so-called) being effected by the growth and multiplication of charac- 
teristic organisms ; and that no such process ever takes place without 
an incessant development of living cells, which grow and multiply by 
consuming a portion of^the fermentable material; the two phe- 
nomena, viz : the chemical change, and the organic growth, com- 
mencing ana ending simultaneously. His experiments have shown 
that free access of air cannot induce fermentation without the presence 
of these organic germs. 

The fact that organisms of the same class are constantly present in 
certain infectious diseases has led to the belief that they bear the same 
causative relation to those diseases as the organisms of fermentation 
do to those processes ; or, in other words, that each infectious disease 
is produced by a specific organic germ. 

Among the principal arguments adduced by the advocates of the 
" germ theory," are — 

1st. The specific or uniform character of diseases of this class, 
their variation being only one of degree, and not of kind. This 
uniformity leads naturally to the conclusion that they are due to a 
specific or uniform cause. 

2d. The permanence or durability of the disease-producing poison 
or germs ; it being well known that they may lie dormant for years 
without losing anything of their potency, showing in this respect a 
perfect correspondence with the organisms of fermentation. 

3d. The period of incubation, or the time that elapses between 
exposure to infection, and the manifestation of the symptoms of 
disease, corresponds with what may plausibly be regarded as the 
period of development of the organisms ; whereas, if the morbific 
agent were an unorganized nitrogenous poison, it would be difiicult 
to understand why it should not produce immediate effects ; and it 
would also be dificult to conceive of its reproducing itself, as the 
infections generally are known to do — another respect in which they 
resemble the organisms of fermentation. It is strongly maintained by 
many observers that putrefying animal and vegetable matters, as 
sewer contents, &c., are incapable of generating typhoid fever, or any 
other specific disease, in the absence of the disease-germs ; but that, 
by furnishing a most congenial habitat, in which the germs, when 
once deposited, can multiply to an indefinite extent, those substances 
become the chief agents in the propagation of such diseases. 

The agency of the parasitic fungi in numerous diseases of the vege- 



ble kingdom, as well as in those affecting certain of the lower orders 
of the animal, is generally conceded. In the disease (mentioned by 
Carpenter and other writers), known as p6brine, which preyailed 
among silk-worms in the south of France, causing an immense annual 
loss to the breeders, the bodies of worms strongly affected with the 
malady were found to be " swarming with minute cylincirical corpus- 
cles, about l-6000th of an inch in length/' Pasteur, who carefully 
investigated the circumstances under which the disease was engen- 
dered, found that it was communicable to healthy worms by the 
transmission of these corpuscles, and that it could be checked and 
eyen exterminated by the adoption of proper measures to prevent 
their growth and spread. It was also found that the corpuscles could 
pass into the undeveloped eggs of the female moth, thus causing the 
hereditary transmission of the disease. It may not be considered 
improbable that researches of this kind may eventually throw some 
light upon the nature and mode of transmission of hereditary disease 
in the human family. 

Communication by Dr. Snowden. 

The summer of 1875 was particularly free from .disease in this 
vicinity. Cholera infantum, which usually prevails on account of the 
bad management of infants among the factory people, was compara- 
tively rare. There were a few cases of dysentery among adults. 

Late in the fall, an herpetic affection of the throat prevailed, but 
not a single case of diphtheria. These cases were soon relieved by the 
internal use of chlorate of potassium, which seemed to have a better 
effect than the use of that salt as a gargle. 

A number of fatal cases of diphtheria occurred in Berlin. 

During the winter months, which were remarkable for warmth and 
dampness, diseases of the respiratory organs were exceedingly preva- 
lent in Winslow, scarcely a family escaping ; while the town of Water- 
ford, four miles distant, enjoyed almost perfect immunity from such 

In Winslow the water in the wells was within two or three feet of 
the surface of the ground, while in Waterford it was fifteen or twenty 
feet from the surface. 

Much has been said of late in the " Journals " against the common 
opinion that unseasonable weather produces disease. The summer 


was unusually cool, and it certainly had no deleterious effect in this 
part of the county ; on the contrary we were unusually exempt from 
disease. The winter was remarkable for its high temperature, and in a 
favorable locality diseases of the respiratory organs were developed to 
an unusual extent, showing, that in suitable localities, diseases inci- 
dent to the unseasonable weather may be developed. 

I note a case of typhoid fever, occurring in a delicate hysterical 
girl, 20 years old, who, owing to excessive nausea, took neither nutri- 
ment or medicines by the mouth for four weeks. I prescribed injec- 
tions of strong beef tea, made from Liebig's extract, and gave her 
medicines in the form of suppositories, with the result of a good 

Watebpobd Works, March 10, 1876. 


Eepoet by Dr. V. M. D. Maroy. 

The only epidemic that has visited our County for the past year, 
has been an influenza, so commonly called " the epizooty.'' We have 
been remarkably free from diseases of an epidemic character, and 
although we have hud about our usual allowance of sickness, there 
have been only our epidemic diseases, and they of a moderate degree 
of severity. There has been some little scarlet fever, whooping-cough, 
measles, diphtheria, &c., but nothing approaching a respectable epi- 
demic. The extreme mildness of the winter months, saved us from 
much pneumonia, rheumatism, &c. 

As to the value of topical applications in malignant sore throat, I 
can only say that while I would not by any means depend upon them 
alone, yet would I as little discard them, believing them to have great 
value as an adjunct to constitutional treatment. Diphtheria is about 
the only form of malignant sore throat we have had here for the last 
fifteen years, and I am satisfied that topical applications are of great 
benefit. Of them all I have found nothing better than nitrate of 
silver and tinct. mur. ferri. After trying seyeral other much vaunted 
applications, I have almost invariably come back to these old " stand 
byes," and rested there. 

The morbid conditions in which calomel is valuable as a therapeu- 
tic agent, are so many and so varied that I know not where to begin. 


I must confess myself to be an ^' old fogy," if to continue to believe 
in the power and efficacy of the hydg. chlor. mit. is to be one. I 
have no sympathy whatever with the " hue and cry " raised against 
this valuable old servant. The effort made to expel it from the mate- 
ria medica, will get no help from me; and while I deprecate the 
abuse of the medicine as much as any one, I must still claim for it all 
that the physicians of olden time did. Its power and benefits are so 
varied, that it would be impossible in this hasty report to begin to 
enumerate them. 
Cape May City, May 9, 1876. 


To Chairman of Standing Committee^ &c. : 

The sanitary condition of this district has been more 
than usually good during the last reportorial year. A 
winter of unusual length and severity, was followed 
by a spring and summer and autumn of remarkable 
healthfulness. The severe and persistent cold of the 
winter was not accompanied with the usual array of 
bronchial affections, doubtless by reason of its even 
severity. The abrupt thermometrical changes incident 
to our climate, bring about most of our respiratory 
troubles. Situated as we are, so near the Delaware 
Bay on the southwest and the seashore eastwardly, 
with the intervening dry land of an entirely level 
mold, it is possible for our people to avoid the mis- 
chievous effects of these sudden and frequent 
variations in temperature, only by timely and suitable 
precautions in the way of clothing and other prevent- 
ive measures. 

Pneumonia and catarrh, when occuning, are usually 
of a sthenic type, at least suflBlciently for a thorough 
purge at the commencement of treatment. They are 


marked, it may truthfully be said, invariably with a 
malarial tinge. The cough accompanying throat and 
chest affections, frequently observes its quotidian or 
tertian exacerbation, with all the precision of a first- 
class intermittent. Remittents occurred casually 
during the last of spring and early summer. These 
more uniform functional derangements are the usual 
miasmatic manifestations in this district, and are all 
that is left us from the extraordinary agricultural 
improvements accomplished in the last lew years. 

Enteric fever is unusual. Other enteric diseases 
were few during the summer, always of a mild form' 
and controlable. Infantile cholera was almost equally 
infrequent through the summer months. The absence 
of the steady oppressing heat usual in July and 
August, tided the little bottle dependents over this 
intensely dangerous part of their career. 

Last autumn was mild and dry, and during this 
portion of the year our district cannot be surpassed 
for healthfulness. Pneumonia occurred occasionally 
during the past winter; our physicians recognized 
quinia as the great remedy. Diphtheria was reported 
as appearing among us. The membranous or her- 
petic sore throats, doubtless, furnished these cases. 
The diagnostic distinction between the two is marked. 
No disease indicates real blood-poisoning, more than 
diphtheria. The general prostration is so noticeable 
and the enlarged cervical glands always accompany 
its presence. When the disease is upon us it is not so 
often or easily cured, as some would feign make us 
believe. Membranous sore throat prevailed exten- 
sively during the latter part of the winter, and though 
of some continuance, under appropriate treatment 
was readily relieved. This throat distemper might be 


said to have existed t 
by a genuine epidei 
affected, complained 
degree of hoarseness 
ages, extending into 
felt as if bound by 8( 
was a general aching. 
the body and limbs, 
of other physicians, 
persons to be so ill, o 
tion, from only a cob 
Dr. Whitaker repo 
throat affections, wit] 
in the city of Millvil! 
occurred epidemical! 
that city. The pblcf 
some of the cases. 
hue, in thirty of t 
Wbitaker's care. A 
doctors in these cas 
cinchon., quinia am 
upon the surface. T 
lead and sulph. sane, 
hue presented in t] 
sisted in prescribing 
in the form of pills, 
ine. Dr. Newell rej 
atism in his prai 
mumps and hoopi 
mother, recently de 
reporter, was Just a 
her accouchment. 1 
the first month. 
A retrospect of 


affections incident to the seasons, and differing 
little from other years. There is observable, how- 
ever, with us a gradual increase of nervous affec- 
tions. How far this may result from the different 
modes of life from former times, it may be suggestive 
to enquire. 

In therapeutics. Dr. Newell recommends chlorate 
of potassium in much larger doses than are ordinarily 
prescribed. He thinks the inefficacy of the remedy 
due to the limited quantity used, rather than to the 
want of remedial value. 

With reference to those two topics whose consider- 
ation you propose — 

1st. The value of topical applications in malignant 
throat-disease. Topical applicationsare important, yet 
subordinate to our general tentative treatment. When 
violently applied, they may only increase the harm. 
Ice in small pieces, allowed to melt in the mouth, are 
invariably grateful to the patient. Cold water com- 
presses or hot moist flannels, as may be most agree- 
able, afford much comfort, A trial of inhalation of 
aqua calcis cannot rightfully be omitted in malig- 
nant diphtheria. Experience declares a proper choice 
from the long array of gargles to be serviceable. 

2d. The morbid conditions in which you rely 
upon calomel as a therapeutic agent. Calomel is 
undoubtedly a beneficial therapeutic agent in the 
hepatic disorders so constantly accompanying our 
summer and autumnal diseases, and especially bene- 
ficial at the beginning of the attack, as a preparatory 
treatment. While calmly regarding the plausible 
theories promulgated, we cannot practice without 
calomel as a therapeutic agent in the morbid condi- 
tions, and in the manner just mentioned. 

T. J. SMITH, Beporter. 
Bbidgeton, May 18, 1876. 



To Chairman of Standing Committee^ t&c. : 

It has been my custom during the years I have acted 
in the capacity of reporter, to forward a circular letter 
to the members of the District Society, asking for 
items of interest to assist me in making my annual 
report. Although the Society has over fifty members, 
I have never received above six replies in any one 
year. It must be apparent that it is almost impos- 
sible for a practitioner whose time is mainly engrossed 
with private • labors which compel him to remain 
within calling distance of his residence, to furnish an 
elaborq,te sanitary history of a county, without in- 
formation which can only be obtained by corres- 
pondence. I trust that, by calling the attention of 
members to this matter, I shall be favored in the future 
by responses from at least a majority of the Society. 

I am indebted to Drs. Holden, Kipp and Pindell, of 
Newark, Pier son, Jr., of Orange, Chandler, of South 
Orange, and Love, of Montclair, for letters of interest 
this year, which favors I desire to acknowledge with 
thanks. The replies therein to the questions pro- 
pounded by the Standing Committee as to the use of 
calomel, and as to the value of topical applications in 
malignant sore throat, will be given in the language 
of their authors. 

Among the diseases of the acute infectious type 
which have' prevailed in our county, the principal are 
diphtheria, measles, rubeola, (" German measles,") 
scarlatina, pertussis and parotitis. Diphtheria raged 
in the city of Newark and its suburbs during the 
colder months, and also in Montclair, proving fatal in 


a large number of cases. Even to this date deaths 
from this malady have been weekly reported. 

The epidemic of German measles was extensive, 
but in no instance did a case show a disposition 
toward severity. The symptoms were such as to war- 
rant its consideration as a malady distinct from 
measles, from which a diagnosis could in the majority 
of cases be easily made ; as, e. g. , the absence of a 
prodromal stage, the mildness or absence of the 
catarrhal features of measles, the color and duration 
of the eruption, the swelling of the sub-auricular and 
superior jugular lymphatic glands ; its occurrence in 
those who were known to have had measles (and that 
too within a period of two months from the time of 
the appearance of the rubeola), &c. 

Cases of hooping-cough and measles are reported at 
present in several localities. Pneumonia has been 
epidemic in Orange, East Orange, and the western 
"part of the city of Newark for the past two months. 

Dr. Love writes that typho-malarial fever broke out 
among the guest-s at the Mt, Prospect House, in Mont- 
clair, about August 1st; the cause, defective sewerage. 
His cases of diphtheria appeared in November and 
later, and seemed to have been caused, in almost every 
instance, by depraved sanitary conditions ; he adds, 
in this connection : "Living as we do in a rapidly 
growing district, where houses containing water- 


Boil not yet saturated with the filth of centuries. 
While considering these matters, if we look further at 
the raids made upon the public health by the sale and 
use of poisons, the pursuit of dangerous trades, the 
eating of diseased meats, the adulterations of food 
and drinks, the bad ventilation of our homes, &c., 
we are led to wonder that the physical condition of 
our people is as good as it is." 

Among modern surgical procedures. Dr. Pierson 
reports the satisfactory employment of the elastic 
ligature in several instances. The following histoi-y 
of one of his cases will be found interesting : ' ' The 
patient was a lady aged 70 years ; case, a malignant 
tumor situated between the left mammary gland and 
the clavicle, measuring in its longer diameter five 
inches, in its shorter three, and in thickness about 
two inches. It had been four years in developing, 
and for four months in a state of ulceration, with 
constant fetid discharge, and an occasional profuse 
hemorrhage ; being so debilitated as to be unable to 
leave her room, it seemed evident that she must soon 
die unless relief was soon afforded her. Removal was 
determined upon, and as the patient objected to the 
use of the knife or cautery, but consented to the use 
of the elastic ligature, it was decided to give it a trial, 
and, with the assistance of Drs. Chandler and Lloyd, 
it was applied on the 17th of June. The patient being 
letherized, a slight cut was made around the base of 
the tumor to form a groove for the ligatun 
armed with a strong thread was passed 
tumor at the centre, by which a double li 
drawn through ; the ends of the elar'" 
tied on either side, thus com 
the mass, a thread being tie'" 


prevent slipping. An anodyne was administered 
nightly, and a solntion of potass, perraang. employed 
as a dressing. The ligature gave very little incon- 
venience ; indeed the general condition of the patient 
began to improve from the time it was applied. On 
the 28th the separation was so nearly complete, that 
the remaining tissue was cut with the scissors, not a 
drop of blood escaping. Cicatrization was complete 
at the end of a month, and the patient's health is now 
as good as that of most persons of her age. A great 
advantage of the ligatnre over the knife in this in- 
stance was that its use was almost bloodless, a point 
of importance in an ansemic patient." 

I have to report a case of Housemaid' s Knee, treated 
by aspiration and the application of a tight bandage, 
with a good result, two months having elapsed since 
the operation, mth no apparent disposition of the 
bursa to enlarge again The trouble had been of six 
months' standing ; it was becoming painful, and was a 
source of no little inconvenience to the patient, who 
had four children looking to her for support. Nearly 
an ounce of a highly albuminous fluid was with- 
drawn, a snug bandage applied, and the patient 
directed to use the limb as little as possible for a few 
days. The tissues anterior to the knee became red 
and somewhat tender, a condition which lasted but a 
short time, leaving the knee quite like its fellow in 

Dr. Pierson replies to the questions of the Stand- 


*'3d. There are no morbid conditions in which I 
rely upon calomel as a therapeutic agent. Many 
years ago I dropped it from my list of remedies 
except as a mild, tasteless cathartic, and as gach very 
seldom administer it." 

Dr. Holden states— 

"1st. My experience has convinced me that any 
malignant disease of the respiratory passage not di- 
rectly the result of local inoculation is to be reached 
by constitutional remedies, and that local treatment is 
but the adjuvant to remove effete and offending mat- 
ter or prevent blocking up of the respiratory tract, 
and therefore that escharotics, solvents, alteratives 
and diluents may be beneficial, but not per se cura- 
tive ; and I must add, as a point of importance, that 
salicylic acid has, in my hands, so signally failed to 
maintain its quasi reputation, that I do not now resort 
to it. 

" 9d. As to the morbid conditions in which calomel 
is relied upon, I have not had occasion to use or pre- 
scribe it but twice in ten years ; believing that while 
its value is unciuestioned, it is pei-fectly easy to suc- 
ceed ™i^^ nthar anri 1oa« TiTiTinTiiilar rBmcrllca Tf is 



not c 


thro.ughout all the mucous membranes involved, as 
well as in the fluids of the mouth. Mechanical de- 
tachment wounds the mucous surface, affording an 
entrance for products of decomposition into the tissues. 
I believe that the use of anti-septic and disinfecting 
solutions as gargles, or washes applied with the syringe 
or atomizer, may be useful in destroying infection and 
preventing general poisoning, but they d6 not limit 
the inflammation nor the exudation. To accomplish 
this object our only hope is in producing an abundant 
and rapid suppuration, for which hot vapor is the only 
topical application which gives any prospect of doing 

"2d. I rely upon calomel in iritis and inflamma- 
tion of the deeper parts of the eye ; in primary, 
secondary and congenital syphilis ; infantile diarrhoea, 
cholera and indigestion ; to increase biliary secretions ; 
to allay some forms of vomiting ; in some skin dis- 
eases, both internally and externally; and, finally, 
whenever I wish to alter nutrition by affecting the 
blood-making organs." 

Dr. Kipp "uses calomel as a topical application in 
phlyctenular conjunctivitis with most gratifying re- 
sults. It is dusted into the. conjunctival sac, and 
removed with a sponge a few minutes later." He 
" uses it in all forms of syphilitic eye affections, 
although he prefers inunctions." He places more 
reliance upon the mercurials in syphilitic eye diseases 
than upon any other remedy or remedies. 

Dr. Chandler writes: "My experience with reme- 
dies applied locally, for the treatment of malignant 
sore throat, has been quite limited. In four cases of 
diphtheria I used salicylic acid in solution in water 
and glycerin p ^z^' ^^ ad. §i.) The tonsils and pharynx 


were painted three times daily with this solntion. 
Two of the cases recoTered very qnickly, the mem- 
brane disappearing in two or three days. The other 
two cases presented more severe constitntional symp- 
toms, and aa local treatment did not seem to check the 
local manifestation of the disease, I did not dare 
longer to withhold constitntional treatment. Tr. fern, 
chl. was ordered, and both cases nltimately recovered. 
The iron acts nndoobtedly as a strong local applica- 
tion, but as a constitntional remedy exerts its greatest 
beneficial influence." 

Dr. Pindell states : " As to the value of topical ap- 
plications in malignant sore throat, I confess to a firm 
belief in their utility, and am perfectly satisfied that I 
have seen many rescued from the very jaws of death 
by their use. It may be proper to say that steam is 
the most important, medicated with salicylic acid, sul- 
phuric and carbolic acids. Mur. quinije and chl. 
potass, in powder to the fauces every hour or two, are 
of service." He remarks upon the value of mercurials 
in a variety of morbid conditions, without making 
special reference to calomel. 


East Obaxgb, N. J., Hay ISth, 1876. 

To Chairman of Standing CommiUee, &:c. : 

The health of our county during th- 
been up to the ordinary average, 
if increased, owes it to epidemic 
infants. No marked peculiaT' 
of last summer. Diarrhea* 


of cholera morbus were not especially frequent or 
severe. Cholera infantum was mild and manageable. 
The fevers of oar section, viz: — remittents of various 
types, were of ordinary frequency, and generally 
amenable to vis naturje. Typhoid, rare. 

Hooping cough has prevailed extensively, being 
persistent, ratlier than peculiar ; quite fatal to those 
infants who contracted the disease very early in life ; 
in those of more advanced months, is oftener a source 
of vexation than of anxiety. The present epidemic is 
long drawn out ; our visitation began many months 
ago, and even yet, the voice of the hoopist is heard 
in the land. 

We have also gone under the rod of scarlatina. 
Very different is this present epidemic from that of 
three years ago. Then there were many cases and few 
deaths ; now, with comparatively few cases, there are 
very many who die, either of the original violence of 
the outset, w of the throat complications, or of the 
nephritic or constitutional sequel*. 

In the neighborhood of Paulsboro, diphtheria has 
prevailed as an epidemic, for a time very fatally. 
During the colder months, plain, honest cases of bron- 
chitis, pleuritis or pneumonitis were unusually rare ; 
but in their stead we hear of minor ailments, of 
which it may be said, that their name is legion. 
So unusual is the number of these, and so uniform 

208 MEDICAL f 

of existing or pred 
leading characterist 
cold that's going an 
at the onset, rest, 
qninia, form a gent 
over the period o 
decline of the attacl 

Since onr last repi 
Br. Jacob Fisler. 

Your qnestiona, p 
ed considerable int 
determine the opin 
enbject of mercury 
large, at our last me 
London. Following 
general discussion ei 
the thesis to this rep 
applications in malig 
Bentiment may be th 
displays itself main 
tions are of decide 
constitutional, they 
Nitrate of silver, so 
varions dilutions, an 
escharotics most in n 
occasionally tried. 

I have tabulated tl 
in regard to mercury 

Nnmber of ttioie vho find 

" who use mercury 
" wbo think mercu 


Number who useit asaa tmtisjpbilitic, .... 6 

" " do not nee it as an " 10 

" who use it as an anthelmintic, 13 

" " " purgative, 18 

" " " adjuvant, 16 

" " in malaritemia 13 

" " avoid itB use in anemia 19 

I find that our Society embraces every extreme of 
opinion upon the general and special utility of mer- 
cury ; one extreme being expressed by such 
sentences as the following, which are literal quota- 
tions : " When I don't know just what ails a 
patient, I give him bine mass, and wait." " It is with 
me, alpha and omega." " It is my right bower." 

The other extreme is represented by the cerebrum 
of our Society, our secretary. He agreed with the 
essayist in regarding the essential action of mercury 
to be a destructive one ; but he thought that whether 
this destructive infiaence was exerted more upon the 
diseased than upon healthy structures depended upon 
their relative strength. That in all diseased condi- 
tions, health and disease strove for the mastery. 
Whenever the one or the other obtained the suprem- 
acy, a crisis was reached. That mercury hastens this 
crisis, this turning-point ; but as it may turn either way, 
either to health restored or to death hastened, it 
becomes a dangerous medicine in the hands of ignor- 

At this present writing, we are enjoying the compar- 
ative immunity from disease whicli May generally 


Therapeutics of Mercury. 


" What are the morbid conditions in which we rely upon Mercury 
as a therapeutic agent ? " 

Mercury has been used in every known disease. We now ask, in 
which of these do we rdy upon it, as not only really indicated, but as 
especially curative in its action. A more enumeration by name of 
all the various diseases to which, in some part of their course, Mercury 
is applicable, would be as valueless in its results as it would be 
tedious in its perusal. So in answering this question we shall not be 
content with furnishing a mere list of individual diseases, but shall 
endeavor to establish those great groupings of perverted actiou — 
those ^^ morbid conditions," each embracing large numbers of sepa- 
rate and distinct diseases, in which, by almost universal consent, Mer- 
cury is used and valued. By ^^ Mercury " in our question is meant that 
action of any combination into which mercury enters, which we recog- 
nize to be essentially the mercwnal action. For although each individual 
preparation of mercury is characterized by some effects peculiar to itself, 
there are certain general medical properties belonging to the whole class. 
And it is this essential property pertaining to all the combinations of 
Mercury that we wish to study under the name of " mercurial 
action." Before proceeding, however, to particularize the "morbid 
conditions " in which we are disposed to rely upon inercury, we shall 
state definitely what elements of therapeutic power we attribute to 
this once-deemed-omnipotent drug. Gleaning from the history of 
medicine and from the medical world of to-day those views of mer- 
cury (whether based upon clinical, empirical or theoretical grounds) 
which have stood the test of time and of opposition, and subjecting 
them to a critical analysis, it will be found, we think, that mercurial 
action has for practical purposes five different modes of expression. 
To state these clearly, we find in mercury : 

1. A power peculiar to mercury, whose mode of action is utterly 
undetermined — a specific action. 

2. The power to modify the structural organization of the effused 
products of infiammation — an antiplastie action. 

8. The power to cause the breaking down and removal of abnormal 
growths and deposits — a resolvent action. 


4. The power to atimulate certain ttssnes, influence secreting action, 
and hasten nutritional cbanges— an alterative action. 

G. .A power whicli renders it peculiarlj efficacious as a purgative — 
an evaeuant action. 

Now in this enumeration of the five different expreBsions or thero- 
peatic powers of Mercury, we have ascribed to it several seemingly 
diverse ener^es. Let ua now see whether there is not some hypothesis 
which will reduce these apparently manifold powers to some principle 
more nearly approaching nnity. And, to this end, let ns saj to our- 
selves. Mercury is a mineral poison, its action is the action of a poison ; 
its therapeutic application is still in the nature of a blood-poison — 
nothing more. Let ob imagine, then, that Mercury so far poisons and 
petverta the capabilities and powers of the blood aa to render it 
unable to consummate some of its ulterior functions. Let us suppose 
that it especially attacks the formative power of the blood, that it 
deteriorates its capacity for structural organization, alters the nutritional 
element and debilitates the body of the circulating fluid, breaking . 
down its crasis and entailing an aplastic condition of which salivation 
is in fact the caaae and the expression. The cachexia which accom- 
panies this condition proclaims how deeply the blood is altered. Of 
course there are variona degrees to which this blood-poisoning may 
be carried— from death produceable by a succession of excesuve doses, 
to the slow and gradual introduction which seems to poison the 
bloody without injuring the man. 

Now apply this view of the blood altered and poisoned by Mercury 
to the explanation of the different therapeutic powers of the drug. 
Of course we discard in any attempted explanation the so-called 
"specific" actions of the remedy ; they are by tiUe admittedly inex- 
plicable and undetermined. There remain, then, for elucidation the 
various actions we have called— 1. The Antiplastic ; 3. The Resolv- 
ent ; 8. The Alterative ; 4, The Evacuant. Applying our hypothesis 
to each of these in order, we have first to speak of the antiplastic, or 
that action Mercury which prevents the complete structoral organiza- 

mation of new m&- 
mmation. Now as 
is formed flrom the 
the laws governing 
long these laws ia 


that whicli decrecB that the new foimatiop shall take its character 
and perfection of fltmctnral organization bom the condition of the 
plastic element of the circulating fluid. If the blood, recentlj 
Barging and OTer-charged with ferer, is to depodt in the eye and 
npon the valvee of the heart Ijmph poanencod of fall and perfect 
power of Btmctaral organization, then shall we neccagaril j and always 
have the aynechife of iritis, entuling life-long blindness ; the v^eta- 
tiona of endocarditis, with a terrible Kqoence of valvnlai disorders 
ending but in death. Bnt if thia perfect fonnatiTe power of the 
blood can be, for a time, impured ; if its capability of strnctaral 
organization can be weakened ; if itt plastic element can be broken 
down, then will the resnlting exudation be no longer able to conati- 
tnte a firm barrier to the recnperatire energies, bnt wiU be imperfect 
in stmctare, infirm and amenable to the absorbent powers of the 
system. Bnt how are we to thns impair the formative principle of 
the blood, bow weaken its power of stroctnral organization and 
destroy its plasticity ! How 1 Why, poutm it temporarily — poison it 
ns Hercnry poisons it— poison it as experience his tanght ns to do in 
order to thns reacne tiasnes which would else be hopelessly spoiled. 
Thns wonld we reduce the first of our therapeutic applications of 
Hercnry to onr hypothesis, by showing how the .effused products of 
inflammation tail short to complete structural organisation through the 
poisonous effects of Mercury npon the plastic element of the blood. 

The next therapeutic power of Hercnry of which we speak -is the 
Resolvent, or that property which pertuns to Mercury of removing 
growths, deposits and formations abnormal in character and dtnation. 

To canse the removal of an already existing growth two things are 
neceseary. 1. To stop increased growth and ; 2. To destroy the part 
already formed. If one body of soldiers were bnilding a fortress 
overlooking an enemy's camp, that enemy must send two different 
kinds of forces to overthrow this 
bnilding, and sappers and miners 
already built. And in the human : 
are awuling onr commands. The 
to carry off ondedirable abnomisUl 
softened and broken down and its 
shown, a moment since, that in 1 
power. And further, these abnon 
vidoal cells, each growing, living, < 


replaced by a new .cell dc|prayed and penrerted like itself. Now it 
becomes necessary to so alter the nutrition, the cell formation of this 
mass, that each successiye crop shall haye a weaker hold upon life than 
its immediate predecessors, until the last of this bastard line shall be too 
enfeebled to transndt its deprayity to its offspring. And this we 
accomplish by the poisoning influence of Mercury upon the cell- 
forming medium, the blood. Thus would we account for the Absorbent 
influence of Mercury by showing that the absorbents stimulated by 
Mercury are able to remoye abnormal matter softened and enfeebled 
by its poisoned source, while new growth becomes continually weaker 
and weaker as its fountain is being continually contaminated. 

The next therapeutic power of Mercury of which we shall speak is 
the Alteratiye. This function of Mercury being more composite as 
to its factors, is more difficult to simplify than the preceding ones. 
It is that action of Mercury which stimulates absorbents and gland- 
ular structure ; which produces increased and altered secretion from 
mucous and yisceral glands ; which efliects nutritional changes and 
alters the blood in consistence and constitution ; which hastens the 
decay and separation of effete material, and assists what might be 
termed the moulting process. To produce these effects, it is necessary 
that the circulating fluid should haye increased facility of access to 
the parts it is to influence. It must yisit in augmented quantity the 
minutest capillaries ; it must flnd its way into the penetralia of gland- 
ular structure. The mere presence of the blood in unusual quantity 
and quality in these localities is sufficient to account for the phenom- 
ena we are explaining, without claiming for Mercury any act of specific 
stimulation. For the blood, remember, is not only the natural pabu- 
lum, but the natural stimulant, also, of the parts through which it 
courses. Now the slow and gradual establishment of the poisonous 
effects of Mercury upon the blood has this power of thinning and 
diluting it. And this is just what is needed to giye it that facility of 
access to minute arterioles and capillaries which would be denied to a 
fluid of any greater consistence. Furthermore, this poisonous and 
debilitating influence, extending to the nerye centres, would haye its 
effect upon the yaso-motor system, causing pasaiye dilatation of arte- 
rioles and arterial capillaries, thereby allowing yet freer passage to 
this poisoned blood. Moreoyer, blood poisoned by Mercury yields up 
more readily the materials from which secretions are formed ; it allows 
greater actiyity in all kinds of changes, and by lessening the tenure of 


cell-life, it hastens metamorphosis and giv^s place and occasion for 
new growth. And let us remark here that just this condition is often 
most favorable to the action and potency of many medicines ; thus 
accounting for the clinical fact that many substances will act promptly 
and kindly in connection with, or after the administration of Mercury, 
which were inert or even injurious if used alone or prematurely. 

Thus by its most gradual and mildest influence upon the blood does 
Mercury add to its other claims, those of altering the consistence and 
constitution of the blood, of modifying nutrition, of increasing secre- 
tion, ef stimulating certain tissues, and of hastening changes which 
in many chronic diseases prove salutary. 

We have, lastly, to speak of Mercury in its action as a purgative. 
The mere purgative action is, of course, not due to any poisoning in- 
fluence ; but that the peculiar efficacy of this action is referable to the 
hypothesis we are advancing is at least strongly suggested by the 
following considerations : 1. — We have just shown that Mercury modi- 
fles not only the constitution of the blood, but also its consistence; 
this altered consistence will be attended by an increased tendency to 
exosmosis — a potent factor. 2. — We know the effect of Mercury upon 
the secretions which discharge into the intestinal canal. Many imagine 
that its purgative action is entirely due to these. 3. — It is a clinical 
fact that, under its drastic doses, the epethilium of the intestines is 
rapidly thrown off, and thus the straining and restraining function of 
this protecting membrane is nullified. Now, to a combination of these 
influences, and perhaps of others that we know not of, we attribute the 
peculiar efficacy of this mineral as a purgative. But each of these factors 
is reducible - to the hypothesis of a poisonous action inherent to Mer- 
cury ; hence it follows that their sum total is likewise an expression of 
that same influence, or, in other words, that Mercury owes its peculiar 
ef&cacy as an evacuant to the poisonous influence it exerts generally 
and locally. 

To sum up, then, we consider that the prime action of !Mt rcnry is 
that of a poison to the plastic element of the hlood; and wc iiJ» - -' ! ]«• 
this poisonous action under four heads, viz: the Antiijla-'" 
the Resolvent Action, the Alterative Action, and the Ev-< . :.. 

By now determining what diseases fall under each of the 
can justly estimate the domain of Mercury, or, in the laiv 
question, "in what morbid conditions we rely upon ^Mlio 
therapeutic agent?'' 


I. There are many diseases in which the best experience of the 
medical world agrees that idercnry is our most reliable remedy, bat in 
which we can give no approximation to a satisfactory account of its 
modus operandi ; cannot tell what structures it primarily affects ; can 
trace no sequence of action ; can establish no analogy ; cannot even 
guess at the secret of its influence ; only know that quietly and unob- 
trusively it effects amelioration, improvement, cure. Among the 
morbid conditions thus amenable to mercurial treatment are many of 
the diseases of infancy, affections of the head, eye and skin, not classi- 
fiable on any known pathological basis — worms, inany local diseases, 
but chiefly syphilis. Of this cla€s we say that they yield to the specific 
influence of Mercury, or (to conform to our analysis) to a power peculiar 
to Mercury, whose mode of action is undetermined— utterly so. 

Q. In another large class of morbid conditions we rely upon Mer- 
cury because of its ability to prevent the complete structural organiza- 
tion of the effused products of inflammation. This we have called 
the Antiplastic action of Mercury. We see instances of such morbid 
conditions in endocarditis, pericarditis, pleuritis, and the inflamma- 
tions of serous membranes generally ; in pneumonia, in iritis, in menin- 
gitis and cerebritis and chronic inflammatory affections of the brain, 
in rheumatic inflammations and in some forms of skin diseases. In 
fine, in any inflammatory condition where we wish to influence the 
residts without expecting to exert any influence upon the inflamma- 
tion per 86. 

III. Again, a third class (often occurring because Mercury was not 
properly applied in the preceding class) is that where growths, morbid 
deposits, exudations, and untoward though legitimate results of in- 
flammations, acute and chronic, are to be removed and dissipated; 
and here we rely upon an action of Mercury we have called the Re- 
solvent. Almost all of the second class may, by neglect, become part 
of this ; also such affections as orchitis, indolent abscesses, tumor of 
many kinds, and particularly internal tumors and glandular indura- 

lY. The fourth and perhaps largest class of morbid conditions to 
which we apply Mercury, is that in which we desire, by its peculiar 
kind of stimulation and powers of hastening metamorphosis of tissue, 
to effect such changes in the nutrition and function of certain organs 
that their present secretion and future growth may not partake of 
existing depravity. To this class belong most of the chronic cases 


uneiuble to H«tcarj. Case* of hepatiUa, gastritiB, chronic meaeDteric, 
hepatic, inUstinftl and cerebral troables wd chronic glandular in- 
flunmatioQ. Oar fourth class then ia that in which we rel j upon this 
AltATative action of Hetcur;. 

T. At the commencement of very manj acnt« diseases, during their 
coune, and upon many other occauons we avail ourselves of the 
peculiar efScacy of the mercurial purge. It does all, and something 
more than an; other. Oar last clasa, then, of morbid conditions is that 
in which we relj upon Uercary as an Evacoant. 

In answering, then, the question with which we started, we shall 
divide those morbid conditions in which we relj upon Mercury as a 
therapeatic agent into five classes, according to the five different ex- 
presuoQS of therapeutic power we attribute to the remedy. 

The Ist embraces those morbid conditions which do not admit of 
classification upon any pathological grounds, but in which clinic ex- 
perience has proved the reliability of Mercury acting by a peculiar, 
essential and specific power inheront to it. 

The M embraces those conditions where the effused ptodocta of 
inflammation would tend to firm structural organization in localities 
and under circnmstancea detrimental to health. 

The Sd clasa inclades all conditiona where existing, though unde- 
sirable, formations and deposits are to be removed. 

The 4th class consists of all those morbid conditions which we con- 
ceive to be remediable by effecting gradual alteration in the nutrition 
and secretion of certain visceral organs. 

The 5th class is made op of those many occasions upon which we 
avul ourselve 

In fine, the 
specific as in < 
one instance 
poisonous wii 

And now, 1 
conditions w 
agent, and h 
we leave the 
cnssion Merci 
is to the polil 
its action as ti 
the circulatin 


evokiDg temporary actiyitiea as the expense of a heattby circulation ; 
ftfTording relief in emergencies b; depreciating the tme standard of 
value. In adminiitering either Mercury or national finance, we should 
look to a speedy return to a gold basis, and not enter upon a reckless 
exhibition of «ther paper or poison, for salivation is panic ; and 
cachexia, omverBal bankruptcy. 

7b Chairman of Standing Committee, tfec. : 

For the sanitary condition of the connty during the 
statistical year ending May Ist, 1876, I have relied 
to some extent upon the mortuary records, obtained 
from our County Board of Health, and vital etatistics 
as fnruishing confirmatory evidence of one termination 
of disease, which so many members overlook, when 
advising the reporter regarding their experience dur- 
ing the year. Diphtheria has prevailed to an unusual 
extent during all portions of the year. No section of 
the county has escaped this epidemic. Kesidents of 
the most elevated sections, surrounded apparently by 
the most favorable hygienic circumstances, have suf- 
fered alike with the inmate of the tenement house, 
situated on low ground, and where all the existing 
conditions to invite disease seemed present. Various 
degrees of severity have been observed from an attack 


'; to 


r of 


which was certainly diphtheritic), was the accredited 
cause of death in ITJ per cent, of the deaths among 
all ages and from all causes during the year in this 
county. The relation of season to mortality, follows 
the same law as was observed during 1874-5 ; the greatest 
fg;tality, 32 percent., occurring in the fall ; 29 per cent, 
in winter ; 21 per cent, in summer, and 18 per cent, in 
the spring. 

Notwithstanding the vaunted specifics with which 
our medical literature is filled, faithful trials of all 
suggested modes of treatment have, as the excessive 
mortality indicates, been very unsatisfactory, and 
suggest the question, whether reported recoveries in 
the majority of cases are due to the treatment adopted, 
due to some intrinsic tendency we do not understand, 
or have been errors in the diagnosis of the variously 
named lesions simulating diphtheria, which are so 
exceedingly common during the prevalence of this 

By common consent, the term ''malignant sore 
throat," is implied as referring to diphtheria and 
diphtheritic croup, the varied opinions on the treat- 
ment of which express the views of such members of 
the Society as responded to your questions relative 
to local applications. 

Dr. J. H. Vondy finds most benefit from potassii 
chloras and tine, ferri. chloridi., and feels that their 
infiuence for good, used topically, is considerable. 

Dr. J. B. Burdett has used various applications 
locally, some with benefit, and others doing more 
harm than good. He • considers them only valuable 
as adjuncts. Of late years, he has relied upon 
potassii chloras., tannic, carbolic, or salicylic acids, 
chloride of sodium and the tine, ferri. mur., the latter 
in preference to all. 


Dr. H. Mitchell believes caustic and irritating appli- 
cations are hurtful, and has no faith in the utility of 
steam or ice, but thinks from the use of a three or 
five per cent, solution of carbolic acid, locally applied 
every hour, diluted if it occasion much smarting, 
he obtains both antiseptic and anodyne effects. 

Dr. A. A. Lutkins has no confidence whatever in 
the efficacy of local applications. 

Dr. J. Craig has used, with marked benefit, locally, 
the following : tinct. iodini. jss., tine, ferri. mur. ji., 
glycerine, gijss. 

Dr. J. W. Hunt has watched the disease in both its 
mild and aggravated forms, and under various plans 
of treatment in his own and others' hands, and he does 
not believe he has ever seen a case cured by any 
treatment, and is not .satisfied that any treatment 
adopted has shortened the disease or caused the 
result to be more favorable; yet his record of mortality 
is as favorable as any that has come under his notice. 
He has used many drugs, including stimulants, but 
does so no longer; uses potass, chlor. and tine, ferri mur. 
only as local disinfectants of offensive products, and 
has no confidence in quinia; thinks that stimulants 
sometimes lessen the chances of recovery ; uses 
opium when necessary to relieve pain or promote 
sleep, and steam if the breathing is embarrassed. 
Food and plenty of pure air are his great reliances. 
In a word, mild cases, in his experience, recover with- 
out medication, while severe ones will generally run 
their course irrespective of medicine. 

Dr. T. F. Morris uses no lo(3al applications, further 
than the sol. pot. chlor., combined sometimes with 
the tine, ferri. mur. , given frequently in small doses. 
He has tried the preparation so highly recommended 


for local use by Dr. Lewis Smith of New York, i. e,, 
carbolic acid and the per. sulph. of iron ; early use 
of which produced no marked effect, either in miti- 
gating the severity of the disease, or preventing its 
extension. He is convinced that as far as medication 
is concerned, potass, et ferr. are as good as anything. 

Dr. J. R. Forman gives frequent doses of the tr. 
ferri. mur. and potass, chlor. to chUdren, in syrup or 
glycerine, repeated so as to make the application 
almost continuous ; additionally for adults, using 
carbolic acid and lime water as a gargle, often in both 
in form of spray, especially to the nares ; thinks the 
above of value when the membrane is in a nascent 
condition ; of very little use when it distinctly coats 
the parts, and of no use whatever in bad cases, (sep- 
ticsemic. ) 

Personally, I cannot recall where benefit was trace- 
able to a local application, and I could mention 
several where the result seemed positively injurious. 
I did, for a time, suppose I was obtaining unusually 
good effects from alternating doses of the salicylate of 
iron, iodide of potassium and copaiba, but am now 
satisfied I was in error, inasmuch as the average 
results proved about the same as under other methods 
of treatment. Finally, in reference to this disease, 
the many diverse views regarding treatment, the un- 
certainty which follows their execution, as shown by 
the varied resultant effects following the same proced- 
ure in the hands of different practitioners, have fully 
convinced me that it will run a definite course, but 
little modified by medicinal treatment, other than 
sustaining ; in a word, that diphtheria is a self-limited 
disease, and, that independent of those cases in which 
there is an extension of the membrane into the larynx, 


death results from exhaustion. Our attention should 
be directed almost entirely to this latter condition. 
Mild local disinfectants are allowable, but tonics and 
nourishment are indispensable. I am in the habit of 
using the sulphate of cinch6nidia (being much 
cheaper and just as eflSicacious as quinia) in conjunc- 
tion with milk, or cream if it can be procured, raw 
eggs, alcohol in some form, and if the patient will 
tolerate it, raw meat ; when a repugnance to either is 
shown, giving them per enema, being sure that they 
are given often enough to more than supply the neces- 
sary nourishment. This I believed to be rational 
treatment, and I am satisfied shows a result second 
to none with which I am acquainted. If tracheotomy 
becomes necessary, it is then especially indicated. 

Excluding accidents and still-births, 55 per cent, of 
the decedents in this county during the year, were 
under (5) years of age. A comparison of this ratio of 
mortality with many sections of the United States, as 
well as European countries, is exceedingly unfavor- 
able to ourselves. Our Society has devoted much 
time to the solution of this^Tsocial problem, which we 
trust will show resultant effects in the immediate 
future. An efficient Board of Health, vested with the 
authority to enforce sanitary regulations, could reduce 
this mortality in a marked degree. 

Irregular invasions of disease have been noted, 
generally attributable to malarial influences, as they 
soon clear up under generous doses of the cinchonic 
alkaloids. . 

Pneumonia, mostly of an asthenic type, was preva- 
lent as usual during the winter. Scarlet fever, gener- 
ally of a mild form, but in an unusual number of 
instances, followed by acute desquamative nephritis, 
was noticed by several practitioners. 


Rubeola, of a very severe type in many instances, 
has been exceedingly prevalent this spring. A length- 
ened prodromic stage has been in many cases a 
marked feature, and more frequently than usual the 
vaiious seqnelffi have been observed. 

Late in the winter bronchial and intestinal catarrhs 
kept all of OS pretty busy, the foiiner being at one 
time epidemic in its character. Both resolved equally 
well under tonics. 

During last summer gastro -intestinal lesions were 
exceedingly prevalent in our midst. The only other 
contagious fonns of disease that have come under my 
observation, have been variola, pertussis and parotid- 
itis, the former occurring sporadically during the 
entire year, becoming more common during January, 
February and March, but at " 

The experience of most o 
that the past year has beei 
•amount of sickness. 

Your interrogation regard 
remains to be answered, 'Wf 
drug to be obtained from the 
answer to a note sent each 
you, to obtain the desired ii 
that no member of the Societ 
years' experience in the prol 
concerning such a drug, for 
were from old practitioner! 
writes : " I do not rely npoi 
tical agent in any morbid con 

Dr. A. A. Lutkins believi 
value in all acute serous intia 

Dr. J. H. Vondy replies 


true croup, calomel is of great value. In certain 
malarial cases a large dose of calomel and jalap will 
materially aid, if not entirely cure ; and meeting 
occasionally with a patient who insists on a bilious 
condition and insists on a dose of calomel, it is a 
valuable remedy to the medical attendant. 

Dr. T. P. Morris seldom uses calomel, except as a 
cathartic. Bronchial catarrh in children under four 
years of age, attended with considerable vascular con- 
gestion, is in his experience promptly relieved by the 
use of small doses of calomel in connection with 
ipecac and chalk. Equal parts of calomel and pre- 
cipitated chalk, he considers invaluable for dusting 
upon inflamed surfaces. Intertrigo, for instance, is 
promptly relieved and cured when it is applied. 

Dr. J. W. Hunt uses it as a cathartic, and believes 
it is one of the best remedies of its class known to the 
profession. He never uses it in small doses as he did 
when he was a younger man. 

Dr. J. Craig regards the use of calomel in inflam- 
mation of serous membranes as most important ; that 
in the early stages of these affections, given in full 
doses, it exerts an influence distinct from its purgative 
affects, allaying local and general irritation, diminish- 
ing the frequency and force of the pulse, and lowering 
the temperature of the body. Administered in small 
doses, say one or two grains combined with one grain 
of opium each, one, two, or three hours, dependent 
on the amount of pain, and continued until ptyalism 
is produced, the most forms of acute serous inflamma- 
tions uniformly subside. He has yet to see a case 
succumb in which this treatment was adopted. It is 
also useful as a cathartic, and as a stimulant to the 
secretory function of the liver, also to deplete from the 


portal circulation. Finally, as a commencing step in 
the treatment of many complaints, he prescribes a full 
dose of calomel when the tongue is furred and there 
is lassitude, headache, loss of appetite, nausea, etc. 
Grreat relief follows its use when these symptoms are 
present, whatever pathological condition may be their 
I append two cases which may prove of interest. 

LEONARD J. GORDON, Repcyrt&r. 
Jbbssy City, May 18, 1875. 

The Treatment of a Case of Tape Worm. 


The patient, a young man 19 years of age, a native of the United 
States, strong and robust in appearance, had apparently enjoyed excel- 
lent health up to a short time before consulting me. For a few months 
previous to this be had passed, at varying intervals, a large quantity of 
tape- worm, the existence of which he failed to make known, both from 
a mistaken delicacy and an erroneous idea as to the nature of his affec- 
tion. As compared with his previous condition, there was noticeable 
during these later months a deterioration in health and strength, slight 
nervous symptoms, in the shape of muscular twitchings, resembling 
chorsBic. manifestations, with a sense of fatigue upon slight exertion, 
apathy, diarrhcBa, and Some disturbance of the digestive functions, 
the appetite however being generally good, though not excessive. 
The administration of ten grains each of calomel and soda, and after- 
ward an ounce of castor oil, was followed by the evacuation of a large 
portion of the worm. A short time elapsed when it was again passed, 
at which time and during its subsequent appearance, various remedies 
were used. Castor oil and spts. turpentine aa §8S, brought about a 
further expulsion. Kousso was tried, but its nauseant a^d unpleasar' 
character was such, that the patient refused to take ~ ~ 
sufficient to fairly test its merits. Carbolic acid, p^' 
the oil of male fern came next in order. The f^^ 
in two grain doses repeated every hour, wi' 
morning upon getting up. At the first * 


taken, seyeral feet of the worm being again passed. About this 
time — being some months after the commencement of treatment — ^the 
patient was troubled with epistaxis, sometimes very profuse, occurring 
upon the slightest cause — often from no apparent cause whatever — and 
continuing to such an extent as to occasion alarm, and reduce him to 
a condition of excessive anaemia. These hemorrhages were coincident 
with the evacuation of small fragments of the worm, and at first this 
association seemed to pomt to a cause aside from mere coincidence ; 
but as the epistaxis finally ceased, although the worm was still voided, 
I attributed the circumstance to its probably true cause, namely, a 
deterioration of the general health, and a defibrination of the blood, 
giving rise to tardy coagulation. He was put upon the tr. ferri. mur., 
and improved. The carbolic acid treatment was again resorted to, 
but with no marked success. Sulph. ether was next tried in doses of 
^ss., preceded and followed by cathartics, but with no results what- 
ever. The first trial of the male fern, given in ^ss. doses, also preceded 
and followed by cathartics, was to a certain extent satisfactory, 
inasmuch as a large quantity of the tape- worm came away, and it was 
hoped the head also. Owing to the patient being activel]^ engaged in 
business, and his inability to subject himself to satisfactory treatment, 
the progress of the case was much retarded, the remedies prescribed 
being often taken with irregularity, or not carried far enough to fairly 
test their effect, as well as rendering it impossible to make proper 
search for the head of the worm, thus necessitating a somewhat 
empirical treatment. However, symptoms of a nervous character set- 
ting in more markedly, the patient's health becoming manifestly 
impaired, with increased gastric irritability and diarrhcBa, I again had 
resort to the oil of male fern, the trial being more thorough than the 
first. Before retiring, the patient took a mild cathartic (castor oil and 
spts. turpentine) which operated during the night. The next morn- 
ing ol. filix mas. 3j* was taken at 6 o'clock, the same quantity at 7.80 
and again at 8.30 o'clock. At 6 o'clock that evening, a much larger 
quantity of the worm was evacuated than at any previous time, which 
upon examination of all thkt I could obtain, led me to conclude that 
either the entire worm had been passed, or that only the head re- 
mained. (The patient during the administration of the remedy had 
abstained from food.) Hoping to make matters sure, another dose 
was given tl\e following morning, after which nothing was seen of the 
worm for over six months. The patient's health greatly improved, 



there were no farther symptoms of a morbid nature, and I was just 
congratulating myself upon a cure being effected, when I received 
the by no means pleasant information that the worm had again 
made its appearance. 

The above notes were written at a time when a cure was supposed 
to have been effected ; my intention being to show the efficacy of cer- 
tain remedies which are supposed to operate with fatal effect upon 
this worm. The efforts of practitioners seldom meet with more stub- 
born resistance than is afforded in the treatment of certain cases of 
tape- worm ; and although the above brief history has not yet been 
brought to a successful close by the entire expulsion of the worm, I 
am still induced to offer it, as showing the reliance that I believe may 
be placed upon the remedies so far employed. As will be seen from 
the foregoing, the use of calomel, as well as castor oil and turpentine, 
caused only a partial expulsion of the tasnia. I believe it will be 
difficult to obtain the full effects of Kousso, owing to the bulky form 
in which it must be administered, and its exceedingly unpleasant 
character ; while carbolic acid, if at all effective, must be pushed to 
such an extent as to render it objectionable. If the same end can be 
obtained with other agents operating more expeditiously, especially 
BO, if, as many claim, it is also essential for the patient to abstain from 
food during the attempt to expel or destroy the worm. The trial of 
sulph. ether gave a totally negative result ; while that obtained with 
the oil of male fern, leads me to conclude that it will prove entirely 
successful if given imder favorable circumstances, and carried suffi- 
ciently far. 

Traumatic Tetanus. 

BY C. O. VIBRS, M. D. 

Thomas Murphy, aged 27 years, native of Ireland, laborer by occu- 
pation, cut his foot while bathing, July 5, 1875. First called to see 
him two days after receiving injury. On examination found crescent 
shaped wound, located beneath the external malleolus of right foot ; 
superficial, and about one inch in extent, unhealthy in appearance, 
with everted edges ; surrounding tissues much swollen and inflamed, 
the patient being unable to bear his weight upon tbie foot The 
trouble yielded to treatment in the course of a few days. He returned 


to work July 11. I did not see patient again until Sunday, July 18, 
thirteen days from the time he had received the injury. He called 
at my office, complaining that he had taken a heavy cold and could 
not breathe freely, as he felt as if he had a cord drawn tightly about 
the chest, and at times a stiffness of the jaws, with a severe pain in 
the back. He also stated that the trouble was aggravated when he 
exerted himself. « 

I ordered him a cathartic, recommended a Russian bath if conve- 
nient, to be followed by a Dover's powder and quinine on retiring, and 
to let me know immediately if the symptoms increased, as I was 
afraid that he might be developing some serious trouble, (suspecting 
that it might be the. beginning of tetanus). He sent for me in the 
evening, stating that he felt much worse. On calling, I found trismus 
and tetanus fully developed, the spasms recurring every few moments. 
Opisthotanus well marked ; no pain referable to recent injury, though 
the muscles of right side seemed to be more affected during the 
spasms, than those of the left. Temperature high; pulse 130 per 
minute. Ordered ice to the spine immediately (according to Dr. 
Carpenter's mode of treatment), and asafoetida and turpentine enemas, 
to be repeated every three or four hours. I also gave twenty gr. each 
of potas. brom. and chloral hydrate, to be repeated every two hours 
until rest should be obtained, and so on until I should see him again. 

July 19, 9 A. M. Patient slept about three hours since I last saw 
him ; had taken three doses of the chloral and potas. bromide ; had 
had two enemas ; ice being kept tP the occipital and cervical region. 
Pulse 110; tongue much furred; perspiring freely; spasms recurring 
once every twenty minutes, and sometimes more frequently, though 
somewhat modified at times. He cannot speak, as every effort at talk- 
ing brings on a spasm. Has taken no nourishment since yesterday 

The treatment to be continued as before— bladders of ice to the 
spine, and all the milk that he can take. 5 P. M., pulse 115 ; has 
lacerated tongue, and keeps an iron spoon handle between the teeth^ 
He has succeeded in taking a quart of milk during the day. Visitors 
have annoyed him very much, consequently ordered absolute quiet, 
directing no one but those in attendance to be with him. Ordered 
5 gr. doses of quinine every three hours, in connection with the treat- 
ment as before Dover's powder to be taken at night. 

July 20, 9 A. M. Has slept more during the night, taking a quart 


of milk, and some beef tea in the morning. Pulse 110; treatment 
continued, quinine three times a day. Brandy mixture every two 
hours in table-spoonful doses. 5 P. M., pulse 112 ; treatment the 

July 21. Ask for consultation. Dr. Carpenter saw case with me at 
10 A. 1^. ; advised a more thorough application of ice to the spine. 
Suggests the saturated tinct. of asafoetida with the oil of turpentine, 
to be used as an enema every two hours. Accordingly I ordered ice 
in bladders from the occiput to the coccyx, and the enemas as sug- 
gested. The other treatment as before— takes plenty of nourishment 
in the form of milk, beef tea, &c., brandy mixture. 4 P. M. Patient 
apparently more comfortable ; pulse 105. 

July 22, 10 A. M. Seems a little delirious this morning ; pulse 115 ; 
has slept more than usual ; the circulation seems more feeble on the 
right side than on the left, the muscles being quite rigid. The appli- 
cation of ice somewhat neglected ; insisted on attendants carrying the 
orders out strictly. Order brandy mixture given every hour. 5 P. M. 
Patient seems a little better ; delirium continues ; treatment the same 
as before. 

July 23. Pulse 100; delirium continues; treatment the same; 
mutton broth instead of beef tea, for the day. 

July 24. Pulse 102 ; slept more than usual during the night ; per- 
spires very freely, and complains of the sudamina, which seems to 
annoy him very much. Spasms seem to be modified in severity; 
treatment to be continued. 4 P. IJ. Patient about the same; has 
taken three fresh eggs broken in wine, in connection with his other 

July 25. Patient continues about the same ; treatment continued. 

July 26 and 27. No appreciable change ; treatment the same. 

July 28, 9 A. M. Patient not so well this morning. Pnlse 120 ; 
sweating profusely. He complains of the severity of the enemas, and 
says the ice wets the bed ; accordingly the attendants have neglected 
both, to which I ascribe the change in his condition. Spasms recur 
as often as once every half hour, some of them quite severe ; complains 
of severe soreness in dorsal and lumbar region. Ordered potas. brom. 
and chloral every two hours, as formerly ; injections and ice contin- 
ued. The enemas once every four hours. 5 P. M. Pulse 112 ; patient 
somewhat easier; spasms recurring about once an hour, and much 
lighter. Substitute rubber ice bag for bladder, and change his bed. 


I am using injections less frequent, as he complains bitterly of their 

July 29. Patient seems to improve slowly. Pulse 99; treatment 
the same. 5 P. M. Substitute cannabis indica for the chloral and 
potas. brom. 

July 80 and 81. Treatment the same. Patient^s condition about 
the same ; perhaps the spasms are a little more ftequent. * 

August 1. Attendants have discontinued the ice and injections. 
Patient sitting up at window, where they had carried him. Spasms 
occurring more frequently. I told them that they would surely 
cause his death, if they did not follow the directions. Called at 2 P. M. 
Pound' ice bag dry; spasms recurring every twenty minutes, and 
sometimes oftener. Dr. Carpenter saw case again with me at 5 P. M., 
and insisted upon their carrying out the treatment as directed. 

Aug. 2, 10 A. M. Patient much better. Ice to spine ; treatment 
the same. 

3d, 4th, 5th and 6th, patient continues to improve rapidly. He 
seems quite rational once more. H& feels slight spasms on exertion ; 
pulse ranges between 72 and 90. In connection with his nourishment, 
he takes the citrate of iron and quinine, cannabis ind. in i gr. doses 
three times a day. Up to August 12, treatment the same. Still con- 
tinues to improve ; can walk with assistance from bed to chair ; sits 
up two or three hours a day. 

Aug. 17. Can walk back and forwards across the floor with assist- 
ance. Fid. nourishments continued, all solids being positively forbid- 
den. Ice discontinued entirely. No medicines except the tonic 

September 1. Is able to walk out. Complains of pain along the 
spine, and especially in the dorsal region. 

Sept. 20. Thinks he is able to return to work ; says he feels quite 
able to do light work. He resumed labor Sept. 25. About the 
middle of October, he went to California, without settling his drug 
and doctor^s bills, and that is the last I have heard of him. 

Jersey City, May, 1876. 



To Chairman of Standing Oommittee^ &c. : 

The health of the County of Hunterdon during the 
past year seems to have been unusually good. Epi- 
demics there have been, but mildness of type has been 
their leading feature. In the upper part of the county 
there has prevailed at various times during the year 
scarlatina and diphtheria ; but in the vicinity of Little 
York, Dr. Night informs me, there has been almost an 
absence of epidemics of any kind. 

In the region of Quakertown, Dr. M. Abel 
says: *^ Diphtheria has prevailed almost the whole 
year. The type of the ailment has been mild, and 
from it there have resulted but few deaths." He men- 
tions a case of this malady in which, as a sequela, 
there occurred paralysis of the muscles of deglutition, 
and the patient, a boy about 18 years old, died of 

Dr. J. S. Cramer, of Sergeantsville, tells me that 
in his practice there have been no epidemics except an 
influenza during the month of March. 

Dr. O. H. Sproul, of Stockton, says the people of 
that village and vicinity have been remarkably free 
from ailments. 

The physicians of Lambertville, T. H. Studdiford 
and G. H. Larison, tell me that at various times 
during the whole year they have been called to pre- 
scribe foi: cases of scarlatina and of diphtheria. They 
say the type of these ailments has not been as grave as 
is usual in that locality. 

Dr. T. H. Studdiford reports his experience with dry 
cotton as a dressing to fresh wounds, and warmly com- 


mends it to the consideration of the members of the 

Dr. A. S. Pitinger, of Clover Hill, states that with 
the exception of the influenza occurring in March, he 
has seen no epidemics ; and that during the year there 
has been very little sickness in his vicinity. 

Dr. George Bartow writes me : ' ' We have had 
during this winter and spring a sort of epidemic 
catarrh. The peculiarity seems to be that even the 
slightest cases are accompanied with an unusual 
amount of debility; and in the severer affections 
convalesence has been unusually protracted." Dr. 
Bartow also states a case of poisoning from tincture 
of iodine, which he successfully treated with copious 
drafts of starch and the hypodermic use of morphia. 
He also mentions a case of poisoning from belladonna 
successfully treated with morphia. 

At Eingoes and in the vicinity of this village, there 
has been very little sickness since the first of last May, 
excepting during the months of February and March. 
During the autumnal months there occurred a few 
cases of scarlatina anginosa, and a few cases of diph- 
theria. Although some of them were slow to over- 
come the force of the disease, yet finally they all 
recovered. Typhoid enteritis made its appearance here 
about the first of December. It was of mild type and 
needed very little medication. Pneumonia prevailed 
during February. March brought us, as it usually 
does, influenza. This year it assumed a typhoid 
character and demanded a sustaining treatment. 

So regularly are we troubled in this valley with an 
ailment of the air-passages at the advent of spring, 
that I am inclined to add a few remarks concerning its 
annual occurrence, its symptoms and its probable 


causes. Ever since February of 1863 I have observed 
that as the weather peculiar to March comes on, the 
people, to an extent greater or less, in proportion as 
the transition from cold weather to warm is more or less 
rapid, suffer from sneezing, suffusion of the eyes, loss 
of taste, pain in the forehead, restlessness, pain in the 
limbs and a febrile movement. Upon the second or 
third day, usually a discharge from the nostrils and a 
cough supervenes. Soon the cough is attended with 
an expectoration, more or less copious, and the patient 
becomes convalescent. Usually the mucus membrane 
lining the air-passages is all that seems, to any extent, 
to suffer. But in the epidemic which this year became 
manifest upon the 4th of March, other structures be- 
came involved. Along with the usual symptoms were 
noticeable torpidity of the liver, kidneys and bowels. 
Considerable delirium attended many cases, and in 
some there was obstinate constipation. As a sequela, 
in many cases there occurred dropsy, in others jaun- 
dice ; while all were slow to regain the gustatory sense. 
An anodyne and sedative course of treatment has 
usually answered all demands of this disease. But 
this spring alteratives, eccritics and tonics have been in 
much request ; and, in many cases, medication has 
been needed for from fourteen to twenty days. Under 
my observation no case ran into pneumonia, although 
many were confined to the bed for twelve days and 
upwards, and suffered free expectoration and much 
thoracic pain. 

Concerning the annual occurrence of this malady, I 
have made some observations. There seems to be no 
fixed time in the spring at which it appears. It seems 
rather to depend upon the temperature and the condi- 
tion of the weather. I have observed its occurrence in 


the latter part of February, and I have noted its post- 
ponement till almost the first of April ; but always it 
makes its appearance at the breaking up of winter and 
the advent of spring. 

A query arises in my mind whether this disease, 
which I am inclined to call ^'Vernal Influenza," is not 
the result of a blood-poisoning generated by breathing 
an atmosphere infested with some organisms — vegeta- 
ble or animal — of microscopic dimensions, which are 
annually called into active life at the ushering in of 
spring. Perhaps there are organisms adapted to this 
transition season that go through all their rounds of 
active life at the time of, or just prior to, the appear- 
ance of our epidemic, and then lay dormant the rest 
of the year. Perhaps they cannot endure colder 
weather; perhaps they are not suited to a warmer 
atmosphere, but fully adapted to this transition season. 
Upon this hypothesis we see that the disease would be 
likely to be severer as the transition period is longer, 
since, if the transition season is longer, it would allow 
them to develop more abundantly, other things being 
equal, and we would be subjected to the breathing of 
them for a longer time. 

In favor of this view is the fact that those whose 
dwellings are in the warmest places, are the first to 
contract the ailment. Sheltered places, and such as 
are flanked upon the wind-side by hills or woodlands, 
are the first to show the prevalence of this disease ; 
while bleak north sides and elevated regions, either 
show it later in the season, or else do not have it at all. 
I do not think this ailment is confined to this little 
valley ; but perhaps its manifestations are more ap- 
parent here than in most places. 

C. W. LARISON, BepoTter. 
HiNGQBS, N. J., May 1st, 1876. 



To Chairman of Standing Committee^ &c. : 

The diseases that have been prevalent during the last 
year, have presented nothing unusual in their nature 
from those of the previous, with this exception, a 
slight epidemic of diphtheria in the fall, and a general 
epidemic of bronchial catarrh, wliich has just sub- 

The epidemic of diphtheria was at first very malig- 
nant in character, carrying off, at times, three or four 
in some families ; but its virulency soon disappeared, 
and the number of deaths on the whole among those 
who were attacked, was quite limited. A contagious 
element was manifested, as a diffusion through a lim- 
ited district could be traced to one or two centres. 

The membrane was developed for the^ most part in 
throat and nasal cavities, although there was a fatal 
case where a patch first formed on the vulva of a 
young child, where there had been an abrasion of the 
skin, from a severe fall. 

We are unable in Mercer county to get at the rate 
of mortality, owing to there being no board of vital 
statistics ; and in cases of death, certificates as to the 
cause are not required. 

Local treatment has the endorsement for the most 
part of the Society, and the sub-sulphate and muriated 
tinct. of iron have the preference, although chlorin- 
ated and other gargles are recommended, together 
with the use of atomized and other warm vapors. 

The general tonic treatment is in all cases 
out. The use of disinfectants, and the se*" 
children in a household where ther" 


together, is also advised, besides strict attention to all 
hygienic laws. 

In regard to bronchial catarrh, it has been wide- 
spread in the county, and came on with pain in the 
head, throat and limbs. The prostration was unasaal, 
respirations difficult, and in some, even of an adalt 
age, there was croupous breathing. The expectoration 
was slight and in many cases there was a marked ten- 
dency towards pneumonia. It was for the most part 
self-eliminating. There was but little treatment neces- 

Typhoid fever and pneumonia have presented 
scattered cases. Malarial fevers are on the decrease. 

A very animated discussion as to the portability of 
puerperal fever, occurred in the spring of 1875, among 
the medical practitioners of this Society, which found 
its way into the courts. Very extreme views were 
advanced, but on the whole, the careful use of disin- 
fectants, strict attention to hygienic rules, and great 
care on the part of the physician, in order to prevent 
contagion, were all that were required. It was not 
deemed necessary, as some insisted, that a physician 
should abstain from practice for months ; such a 
regulation would be impossible to carry out, and not 
demanded by the contagion. 

Scarlet fever has been rather more diflFased than 
usual. Dr. Bodine had fifteen cases under his charge 
in the Children's Home ; his communication is enclos- 


tent fever, which were found to be greatly benefited 
by large doses of quinine, as recommended by Lieber- 
meister in Ziemssen's Cyclopaedia. Influenza was 
general since mid-winter, and nearly all persons were 

The Mercer County Medical Society is in a flourish- 
ing condition, and great interest is taken in the debates 
on the leading medical topics of the day. 

Trbnton, N. J., May 10th, 1876. 

Monsel's Solution of Iron in Diphtheria. 


Without wishing to discuss at length the origin of diphtheria, its 
mode of development, and the circumstances attending its diffusion 
in a community, I will briefly refer to these points, and consider 
its treatment: 

I. Its Origin.— Like most epidemic diseases, its nature is so subtle 
as to have as yet escaped our detection. Different theories are ad- 
vanced, some very seductive, particularly that of the Spore theory, 
which is very ingenious, but far from being convincing. Diseased 
tissue affords germinating spots for bacteria to develope in, but they 
can hardly be looked upon as the primary cause of diphtheria. 

Our present knowledge on this subject may be summed up as this : 
that under peculiar atmospheric conditions an accumulation of morbid 
material occurs, which material may be presumed to be always present, 
and at such times any person or persons who are in the vicinity of such 
a collection, and in fit condition for its action, will contract a specific 
disease, and become a centre or centres from which it may be diffused 
to others. 

n. Its Development — Prom a careful study of this, b find tl :: 
mucus membranes are the channels for its introd' 
denuded surfaces. The morbific matter excites ' 
mation of a specific character at a definite poL 
and putrid exudations are formed, and in th*" 
numbers of organized growths. The system 


turbed actions, by passing into a low irritative fever, and if the 
diseased action continue, morbific matter is absorbed, the glands in 
the vicinity of the diseased surface swell and becomes engorged, and 
through them toxic symptoms soon develop. 

I think that this can be accepted as the history of the mass of col- 
lected cases ; although there can be no doubt that under . peculiar 
circumstances, the morbific matter may be so virulent, and the state 
of the system of the recipient so unusual, that death may occur 
without any local manifestion. We may, therefore, consider the 
disease at first localized and afterwards general. 

IIL Its Diffudon, — Its epidemic nature cannot be doubted. That 
it is contagious the clinical history proves conclusively. The morbific 
element is found not only in the membranes but ii» the emanations 
from the diseased subject. 

Treatment. — Adopting the view that the disease is at first localized, 
and that a series of morbid changes take place before general blood 
poisoning, it is fair to infer that if we possess a remedy that will 
destroy the poison, prevent absorption, and expel diseased membranes, 
or at least change their structure, we can accomplish a cure. 

Prom eight years experience with Monsel's Solution of Iron, and 
comparing results with other methods of treatment, I think it promises 
better success than any other remedy yet ofifered to the profession. 
The conditions under which it is to be used are these : that the diph- 
theritic spot is in such a position as to allow the solution to be applied 
in the manner soen to be described. 

When the sub-sulphate of iron, made after the formula in the U. S. 
Dispensatory, is used in full strength on a diphtheritic patch, located in 
the fauces, the following effects are observed : 

1st. A thickening and toughening of the membrane. 

2d. Intense constriction of the mucous membrane behind, separat- 
ing it from the diphtheritic mass above. 

3d. A sensation of strangulation, together, in most cases, with 
vomiting of the membrane in mass, leaving the throat clear, and the 
mucous membrane in a condition unfitted for absorption from corruga- 
tion of its vessels and lymphatics. 

This act of vomiting is of great asssistance to the patients, particu- 
larly the young, as it enables them to reject a substance unfitted for 
digestion, and apt to induce, if swallowed, diarrhoea and other intes- 
tinal difiiculties. 


The manner of applying the solution is of the greatest importance, 
and requires careful consideration ; for with this as with many excel- 
lent remedies, everything depends upon a thorough use, and given in 
proper strength. I generally take a tumbler, and by inverting it, 
make use of the small concavity in the bottom. Into this the iron is 
dropped in full strength, and in amount sufficient for one application ; 
to this an equal proportion of water is added if the case is that of a 
child, for an adult almost full strength is required ; then with a camel's 
hair pencil of large size, the tongue being depressed, and a good view 
of the throat obtained, the solution is put on the diseased part Im- 
mediately the patient experiences a feeling of sufifbcation, and is seized 
with retching and vomiting ; the membrane is in most cases then ex- 
pelled in mass, and the throat cleared. The flow of saliva is increased, 
as are other secretions in the mouth. 

I have often succeeded, after 'one application only, to get patients 
to take a quantity of nutrition, when for days they have been unable 
to swallow, owing to the mechanical obstruction of thickened putrid 

For diphtheria of the mouth, throat, and in fact for all places where 
the brush can be used, the treatment with iron promises the most flat- 
tering results ; but in parts where it has from necessity to be greatly 
diluted, and in those cases where the lymphatics and glands are swol- 
len, showing toxic absorption, and the system impregnated with poi- 
son, it is of but little value, and stands on a par with other remedies. 

A too frequent use is injurious, and two or three applications in 
twenty-four hours are sufficient. 

In conj auction with the above preparation, the general tonic plan 
of treatment is to be fully carried out. The disease is epidemic and 
of an " acute infectious nature." The strictest attention should be 
paid to the hygienic conditions surrounding the patient, and all ex- 
cretions, particularly from the mouth, throat and bowels, should be 
carefully avoided and disinfected. A case occurring in a family 
where there are other young children, calls for their isolation at once. 
The use of chlorine should be free in the house, andjas much^ventila- 
tion allowed as the season of the year will permit. 

Note.— Cases illustrating the effects of the iron were cited in my original ar- 
ticle, but have to be here omitted. I quote but one to show the bad result of 
its too frequent use : 

Deo. 14th, 1878.— Was summoned to attend Mr. R , a merchant living in 


H street. Found him sitting propped in a obair, complaining of intense 

suffocation. Wife stated that that afternoon he had complained of sore throat, 
and having used MonsePs solution a year before, when he had diphtheria, with 
good results, he had now resorted to it himself, and used it every hour in full 
strength, at least six or eight times. His throat was literally filled with crusts 
of iron, and so constricted thac the suffering was intense. It was some hours 
before I could afford him relief. 
Trenton, May, 1876. 

* Communication by Dr. Joseph L. Bodine. 

In Dr. Richardson's ideal " City of Health," provision is made for 
work-rooms, apart from the house of those engaged in such industrial 
callings as tailoring, dressmaking, shoemaking and the like. As 
illustrating the danger of our present system, he says : '' I have myself 
seen the half -made riding habit that was ultimately to clothe some 
wealthy damsel, rejoicing in her morning ride, act as the coverlet of a 
poor tailor's child, stricken with malignant scarlet fever." We have 
had an example of this mode of communicating the scarlet fever 
poison in a " Children's Home " in Trenton. The mother of one of the 
boys, wishing her child to appear well-dressed at the annual public 
anniversary of the Home^ had undertaken to get a new suit of clothes 
for him. She brought to him a part of the suit, and expressed 
her regret that the coat was not finished. She said that the person 
who was making it had not been able to finish it as promised, because 
there had been scarlet fever in the family. In a few days after the 
anniversary, this boy who had put on the poisoned garment, was sick 
with scarlet fever, and the disease spread through the Home until 
seventeen of the fifty-three children in the institution had been 
brought under its power. Isolation of the sick from the well was 
adopted at the earliest time practicable, and was enforced until the 
disease had disappeared. The epidemic was mild in its form, and the 
cases all got well without complications or sequelsB. It is gratifying 
to the medical attendant of the Home to acknowledge the receipt 
from the lady managers of the institution, of an honorarium or pecu- 
niary acknowledgment for his services during the epidemic. Pecuni- 
ary recognition of medical services to a benevolent institution is so 
rare as to demand mention^ when it is made. 

Tbknton, N. J., April aoth, 1876. 



To Chairman of Standing Committee, &c, : 

The diseases which we have been accustomed to meet 
with have presented themselves without any remarka- 
ble increase in number or severity in type, excepting 
diphtheria and pneumonia, and in some sections of 
the county a tendency, from local causes, of certain 
diseases, to run into a typhoid condition. Diphtheria 
has never, we believe, been so prevalent and of such a 
malignant type as in the city of New Brunswick and 
in South Amboy: and we think it owing largely to 
the neglect of the adoption of proper hygienic or sani- 
tary measures for the prevention and mitigation of 
disease. During the past five or six months there 
have been, according to the statements of our under- 
takers, over 250 deaths from this disease in New 
Brunswick ; and we reckon, from the meagre statistics 
we have been able to collect, that the mortality has 
been about 20 per cent. * From consultation with mem- 
bers of our District Society, resident here, the average 
mortality among their patients has been about 15 per 
cent., which is a very good record when we consider 
(as should of course enter into the calculation) the 
malign'ant type of the epidemic, and the late period in 
the disease when the Doctor was called in a large 
number of the cases. 

From the account given by Dr. Treganowan, we 

* NoTK. — I do not believe that we would have had more than half that per 
oentage of moitality had the physician been called in each instance at the com- 
meuoemeut of the disease. Doubtless manj of the cases tenninated fataUj 
because of interference with the preper treatment. Three casea in mj practice 
were oonvalesoentf but proved fatal by ii^udicious dosing by the mother with 
ipeoao and hive syrup to the extent of severe emeais. 


judge the record in South Amboy to show about the 
same ratio ; of course on a smaller scale. 

From observation in this epidemic, we must come to 
the conclusion that diphtheria is undoubtedly an in- 
fectious disease, but it has not been demonstrated to 
our satisfaction that it is portable. Several families 
which have been invaded have lost two to four 
children, in some instances being all in the family. 

The instances were exceedingly rare where children 
under 18 months have taken the disease, the vast 
majority having been from 3 to 10 or 12 years, between 
which ages was also by far the greatest mortality. 
Adults almost invariably recovered, some of whom 
were severely attacked. The worst case the reporter 
met with was that of a man about 35 years of age, in 
which case the exudation covered the buccal mucous 
membrane, the soft palate, tonsils and mucous mem- 
brane of the pharynx, slightly invading the larynx, so 
that deglutition was exceedingly difficult and painful, 
and the voice could not be raised above a whisper. In 
this case entire recovery has taken place, but the con- 
valescence was exceedingly slow, the "patches'^ not 
disappearing till 12 days had elapsed. The patient 
suffered from partial paralysis of the larynx, but under 
appropriate treatment it rapidly disappeared.. In 
some cases the patients were apparently recovering, 
when suddenly the pulse became much more rapid, 
vomiting ensued, and death resulted in a short time, 
probably caused by some affection of the vagus. 

Dr. Morrogh reports having attended a large number 
of cases, in a few of which there was great disturbance 
of nervous centres with resulting paralysis, but which, 
as in nearly all the cases we have heard of, the 
paralysis yielded quickly to treatment. 



As to treatment, the reporter is convinced and be- 
lieves it is the opinion generally entertained by our 
physicians here, that as. far as the local manifestation 
of the disease is concerned, the less interference with 
the throat the better in the vast majority of cases, 
except the frequent rinsing or gargling with a mild 
disinfectant wash. We enter our earnest protest 
against the removal by violence of the exudation, and 
especially of the use of nitrate of silver. 

Of some of the new remedies suggested during the 
past year or two, they have not given the satisfactory 
results in our practice that we had expected from 
reports of success in other places. 

Dr. Baldwin, in an able pa^er on diphtheria, 
recently prepared, speaking of remedies, says : "It 
would be improper to close this enumeration of reme- 
dies without reference to salicylic acid, which has 
been much praised for its almost specific power. That 
it is a good antiseptic all will admit, but its use in the 
present epidemic, so far as my experience goes, fails 
to j ustif y the high encomiums .which have been placed 
upon it abroad." 

This, we think, will^be abundantly corroborated by 
most of our physicians, if not all, as our experiences 
have been alike in the use of this acid. In my own 
practice I have abandoned it and gone back to the 
carbolic acid gargle, the use of which has been 
productive of far better results. This, with tonic 
treatment, (in which I place sulph. quinia at the 
head of the list), and a good attention to proper diet- 
etic and hygienic management, has given the most 
satisfactory results. I have often found at the com- 
mencement of treatment a remarkable improvement in 
both the local and constitutional condition, resulting I 
from a moderate dose of hydrarg. chlor. mite. 


Pneumonia prevailed to a considerable extent, espe- 
cially among children and the aged, during the winter 
and early spring. More cases than usual terminated 
fatally among the aged, some very suddenly. Among 
the children recovery was almost the invariable result. 
Cholera infantum during the last summer, and rubeola, 
scarlatina, roseola during fall and this spring. Remit- 
tent, intermittent and typhoid fevers have been met 
with in their usual degree of frequency. 

The reports received would seem to indicate less 
intermittent fever in the localities where it has been 
most prevalent, e, .9., South Amboy, and more preva- 
lence in some places where it has not been so frequently 
seen, e, g.^ Dayton. 

Dr. Norton reports throat diseases very prevalent in 
Metuchen and vicinity ; several cases of diphtheria. 

Dr. Holmes, Cranberry, reports a number of cases of 
cholera infantum during the summer. Bilious remittent 
fever, running into typhoid and typhus ; 50 cases re- 
ported, most of them occurring within 300 yards of a 
slaughter house, where were nearly all the fatal cases. 
Pneumonia, bronchitis and diphtheria during Decem- 
ber and January. One case of small- pox, the second 
attack, the first having occurred 9 years previous. At 
ninth day the Doctor counted 71 old scars and 65.pus- 
tules on face. Never vaccinated. 

Dr. Wilson, Monmouth Junction, reports increased 
number cases intermittent fever. Influenza very preva- 
lent, as also throat diseases, but no diphtheria. Several 
cases conjunctivitis and a few of scarlatina. 

Dr. Slack, Dayton, reports more sickness than usual. 
Miasmatic fevers of mild type very prevalent. Several 
cases of ulcerated and membranous sore throat, but 
no true diphtheria. Pneumonia; influenza, affecting 


nearly all the inhabitants, accompanied with high 
fever, lasting two or three days. 

Dr. Treganowan, South Amboy, reports miasmatic 
diseases less prevalent. Fall and winter, diphtheria 
prevailed more than ever, of most malignant type. 
An unusual number of sudden deaths "from what 
appeared to be lung incompetency." During this 
spring catarrhal affections attended with bleeding 
from nose and fauces. Scarlatina now prevailing. 
Cases of epistaxis and hemorrhage from the throat 
and lungs have been more frequently met with than 
usual in various parts of the county, and especially in 
this city. 

Our District Society has been called upon to part 
with another of our oldest members. Dr. Charles Dun- 
ham, who was for several years our Treasurer. The 
Society gave suitable expression to the feeling of sorrow 
in the sad providence which removed from our midst 
one so highly esteemed by us for his professional 
ability and personal qualities. 

D. 0. ENGLISH, Heporter. 
Nbw Bkxjnswick, May 13, 1876. 


To Chairman of Standing Committee^ &c. : 

The general health of the district for the past year 
has been remarkably good, with one or two exceptions. 
Diphtheria of a most malignant type has prevailed at 
Long Branch and vicinity with great mortality, leaving 
few families who do not mourn the early departure of 
some little one, and in some cases it has counted all 
among its victims. Adults have not escaped its con- 


tagion, which there at least is now beyond question. 
I had hoped to obtain some facts and figures from the 
resident physicians, concerning the scourge, but my 
appeal has been in vain. 

Dr. Porman, of Freehold, writes: '' There has been 
one-third less sickness than during any year of the last 
decade, and the death rate has been correspondingly 
low. The only epidemic has been measles, which has 
prevailed in every family not protected by previous 
attack. Diphtheria has prevailed only in a sporadic 
form, and been of a mild type." Dr. Long of same 
place makes a similar report. Concerning topical ap- 
plications in malignant sore-throat, Dr. Forman states 
further: " In patients over three years of age, affected 
with diphtheria, I am in the habit of painting the 
diphtheritic patch at the outset with liq. ferri per- 
sulph., and if the membrane re-appear, I sometimes 
make a second or third application. This usually 
causes the membrane to peel off, and has a tendency to 
check the local disease. In addition I use ice and ice- 
water as a gargle, frequently repeated. I use other 
applications, but consider local treatment secondary in 
importance to constitutional remedies." Concerning 
the therapeutic value of calomel, he replies : " I seldom 
use it, and then as a cathartic ; or, with digitalis and 
squills, as a diuretic in dropsy." This accords with 
Dr. Long also. 

Dr. Welch, of Keyport, makes a similar report. In 
addition, he reports a case of hemorrhage from syphi- 
litic ulcer, whereby the coats of the anterior tibial 
artery had been corroded to that degree the' blood 
burst through, endangering the life of the woman, she 
losing about four pounds of blood. The ferri i)er sulp. 


first, and ligature afterwards, controlled the hemor- 

I have the pleasure of submitting two interesting pa- 
pers by Dr. Geo. T. Welch, of Keyport, and also two 

S. H. HUNT. 

Endocarditis and Embolism producing Paralysis 

AND Gangrene. 

BY 8. n. nUNT, li. D. 

The patient, Capt. Wm. Hayners, Oceanport, aged 66 years, was a 
man weighing in health 225 lbs., 6 feet 1 inch in height, of a nenro- 
Bangaineous temperament. Always enjoyed good health nntil six 
years before this last illness, when he had an attack of inflammatory 
rheumatism, which lasted six weeks ; no cardial trouble as a sequel 
being observed by Dr. Scrivens, the attending physician. Has always 
been a good liyer, using tobacco and stimulants temperately. Retired, 
from business some two years ago, since which time his life has been 
less active. Has had occasional attacks of dyspnoea for the last year, 
from over-exertion or exercise, lasting however but a short time. 

On Sunday evening, March 21st, 1875, he was engaged in a social 
conversation with his sons, when he arose from his chair and walked 
to the stove ; returning, he dropped heavily into his chair and had 
some dyspnoBa, which was observed by the family. He talked bat 
little after this, his intellect seeming to be clouded, and neglected to 
bid his family good-night as was his custom. By great exertion on 
his own part and a little assistance from his wife, he reached his 
bed in another part of the house, but was completely exhausted in 
doing so. 

I saw him in the morning for the first time, and found him with 
partial loss of motion and sensation of the lefb side, able to use his 
leg and arm a little; the left comer of the mouth drawn down; 
tongue very red, and mind acting sluggishly ; speech thick, and yet 
able to articulate indistinctly. By the aid of purgatives, brisk fric- 
tion of the affected limbs, and gentle use of the battery, the parts 
soon regained their usual tone, and in &Ye or ^six days their impair- 
ment waa not noticeable. The muscles of pharynx and mouth 


were also paralyzed. With the restoration of the arm and leg, their 
use continued impaired during his illness for about ^tcn days. The 
mind did not act with its wonted quickness, though his reason was 

On April 1st he complained of intense pain in the right ankle, which 
on examination was found to be swollen. A return of his former rheu- 
matic trouble was anticipated. His feet were put in warm water, gentle 
friction was employed, and then bandaged in cotton. On Friday, April 
3d, his right foot was very much swollen and was found to be below the 
normal temperature. No very marked constitutional effects were ob- 
served, save great restlessness, which continued for several days. Urine 
was scanty and loaded with lithates. Temperature 98 ; tongue very red ; 
pulse 73 and of an intermittent character. The heart, during all his 
illness thus far, seemed to be embarrassed in its movements, though 
no valvular trouble could be detected. 

April 4th. The foot was much swollen, and large purple spots made 
their appearance. Several large blisters were noticed on the side of 
the foot. Patient's symptoms were those of general debility. The 
small and frequent pulse, dry and coated tongue, denoted an asthenic 
state of the system, which was met by quinine, Huxsom's tinct., beef 
tea and milk punch. Dr. Scrivens now saw the case in consultation. 

April 5th. The temperature of foot was found to be 60° and very 
much swollen. The ankle of the left foot was still more swollen and 
(edematous, attributable in a measure to his posture, as he is unable to 
lie in bed, and has been for the last five days, but sleeps in an arm* 
chair. An effort was made to place the foot on a chair, but he could 
not keep it there, owing to the intense pain that straightening the limb 

April 6th. Every phenomena of acute gangrene in the foot was now 
beyond a question, the limb beyond the ankle being of a scarlet hue, 
hot, dry and very painful, while there was a mottled discoloration of 
the foot, and the toes especially had lost all sensation. From April 6th 
there was an increase of the trouble ; still there was no fever until 
Sunday the 11th, when the temperature was 99}°; pulse 76. The 
heart was beating feebly and intermittingly, as if there might have 
been a heart-clot impeding its action. 

April 12th. Temperature 99 ; pulse 92. This condition continued 
until April 19th (April 18th Dr. Van Buren, of N. Y., saw the case). 
On the 20th, temperature fell to 98. Thus the vital powers began to 


give signs of the great battle that was going on in the affected limb. 
The diet of the patient was of the most concentrated and nourishing 
kind, which the patient took freely in connection with his quinine, 
iron and strych. ; tr. digitalis was also given as heart tonic. The 
limb was enveloped in oakum, carbolic acid and per. mang. potas. 
alternately used to correct t^^e cadaverous smell consequent upon 
decomposition. Since the 14th the patient has expressed an unwill- 
ingness to get out of bed, and for the last week has lain there. 
The black discoloration now extends to the ankle, nature having 
formed a line looking much like demarcation. 

This afternoon there is a hectic flush and occasionally a cold sweat 
upon the forehead. Patient shows a disposition to sleep ; is less talk- 
ative, and indifferent to what is going on about him. Swelling of 
left foot subsided soon after going to bed, and is now looking as well 
as ever, though some pain from pressure of heel. 

April 26th. Hectic fever creeps on gradually and stealthily, its inva- 
sion marked only by malaise, restlessness and discomfort, which 
patient is unable to shake off. 

The exacerbation is vesperal, coming on at 4 o'clock daily with 
marked periodicity. Body ordered washed, rabbed and excretions 
removed promptly. Temperature 100; pulse 85 to 00, and inter- 
mitting discoloration shooting up over ankle, beyond supposed limit 
of demarcation, and increased redness near knee. 

April 27th. Delirious during night, wandering in sleep ; perspiring 
freely. From April 27th to June 1st there was a gradual abatement 
of fever, and a general improvement in condition. Appetite good ; 
bowels moved by an occasional injection ; no fever ; very little per- 
spiration ; nothing but restlessness, that occurred periodically, espe- 
cially in the evening, added at all to his discomfort. The rhythm of 
the heart was more normal, with very slight and infrequent intermis- 
sions. Tb# pulse was fuller and stronger, and continued at about 80 
pulsations per minute. There was noticed, a few times, attacks of 
dyspnoBa, which were very slight in their character, and produced 
little or no uneasiness. Patient most of the time was cheerful and 
hopeful, and enjoyed his food with a relish. The line of separation 
occurred two inches above the ankle, and the ulcerative process under 
the limb progressed favorably, showing every sign of extending 
around the limb. A small spot, about the size of a quarter, which 
showed itself about six weeks since, on the left heel, has proved to be 


unmistakably gangrenous, extending to the depth of one inch. This 
came from pressure, and seems to have resolved itself into an ugly, in- 
dolent, gangrenous ulcer, making but little progress towards sloughing. 

From June 1st to June 16th there was the same condition of affairs 
as the month previous, only a general improvement apparent in his 
condition. On Wednesday evening the patient was attacked with 
labored breathing, marked dyspncea, pallid features, profuse perspira- 
tion, frequent and fluttering pulse, and cold extremities. This condi- 
tion lasted for two hours, when the patient sank quietly and without 
a struggle to sleep. His mind was clear, and he conversed with his 
family to the last. 

The history of this case is interesting. There can be but little 
doubt that these troubles were the sequel of his illness six years prior 
to this one, when he was suffering from inflammatory rheumatism. 
IV* Fuller, who is authority on Heart Diseases, says : " Endocarditis 
is unaccompanied (not unfrequently) by symptoms calculated to direct 
attention to the seat of mischief, and would escape detection altogether 
if recourse were not had to the stethoscope. The symptoms are 
characterized by sudden collapse, with pulmonary obstruction or 
cerebral disturbance. The patient becomes suddenly faint, and 
struggles for breath ; the countenance is anxious, face pale and livid, 
pulse rises to 140 and even more, and is weak and irregular both in 
force and rhythm. The surface is cold and covered with a clammy 
perspiration, and is accompanied by tnore or less paralysis. These 
symptoms are connected with the rapid formation of enormous fibrin- 
ous deposits on the valves of the heart, causing great obstruction to 
the circulation or with the detachment or disintegration of fibrinous 
deposits. The most formidable of these symptoms are consequent on 
the detachment of fibrinous deposits from the valves of the heart, 
which are then carried by the circulation into the smaller vessels, and 
cause obstruction of the arterial circulation." The case now reported 
at length had all of the symptoms cited by Dr. Fuller. The gangrene 
of left foot was attributed to an obstruction of the arterial circulation* 
His sudden death, at a time when he promised speedy recovery, was 
also attributed to the detachment of a heart-clot, or embolism. Statis- 
tics and history of other cases sustain the treatment in this — neter to 
amputate where there exists such heart complications, as more recover 
from non-interference than by amputation. No post-mortem was 

EATOirrowN, May, 1876. 


Medullaby Cancer in Mediastinum. 

BY DR. 8. H. HUNT. 

Was called to see Mr. James Reed, aged 82, on Sept. 4th, 1875, who 
was visiting his mother. Learned that he had been sick for about one 
year, off and on. In his last sickness stated that his Doctor said he 
had " inflammation of the lungs." Remembered being thrown on a 
rail fence by a runaway horse, which incapacitated him for several 
days. Has had pain in breast ever since, more or less severe. Found 
patient sitting in chair, head leaning forward on window, gasping for 
air. Dyspnoea increased until he had one of the most desperate 
struggles for breath I have ever witnessed. Pulse was small and 
frequent. Eyes protruding and staring; countenance anxious and 
woe-begone. Skin was clammy, with a cold perspiration from the 
fatigue produced by the respiratory efforts. His beseeching look for 
relief from his intense and unceasing suffering, haunt me yet. Face, 
arms and legs were swollen and purple from the deficient oxygenation. 
His misery was intense and indescribable. This condition of things 
continued for twelve days, until Sept. 16, despite all remedies, with 
with very slight remissions; at which times nature seemed to have 
exhausted her energies in combating the disease, but would rally 
again with desperation to reribw the conflict, which increased with 
the few days he lingered. The temperature never exceeded 100®. 
These were the symptoms presented. 

A physical examination revealed the following: there was an 
enlargement of the left side, a widening and bulging out of the inter- 
costal space, and an absence of respiratory movement. The heart 
was displaced several inches to the right, and the apex beat was 
noticed one inch beyond the right nipple. There was a fullness noticed 
below the ribs, and viscera pressed downward. This gave to the 
abdomen a distended and bloated appearance. There was a complete 
absence of vocal fremitus, and dullness over the whole affected side, 
before and behind. No respiratory murmur could be detected, and 
but little bronchial respiration. No cancerous cachexia was present. 
That there was effusion in the pleural cavity, did not admit of a 
doubt, but there was more to bewilder and confuse. From the time 
I saw him there was universal dullness, and this for one thing led to 


the suspicion that there was a cancerous growth. And yet the case 
was obscure. I learned from his immediate friends that he was of a 
cancerous stock, and that there was a decided hereditary predisposi- 
tion. Since his death, I haye traced the family history up as 
hereafter stated, which is of unusual interest. 

A post-mortem was obtained, after much opposition, which set at 
rest all doubt. An incision was made by my student, F. Parsons, 
from the top of sternum to the symphisis pubis, which fully exposed all 
the viscera. The sternum and ribs were carefully dissected, and by a 
cartilage knife the ribs divided mid-way ; when, on raising it, the 
pleural cavity was found distended, with serous effasion. Attached to 
the inner surface of the sternum, was located a foreign growth, which, 
on examination, proved to be a medullary cancer, weighing over four 
pounds. This consisted of several nodules, which cut like fibro-cartil- 
age, but connected with these was a morbid product of almost every 
variety of consistency. Much of it was soft, white and brain-like, 
breaking up to the touch like brain matter. It appeared as if melted 
lard had been poured into the anterior, posterior and middle media- 
stinum, and then cooled. The left lung was pressed back against 
the posterior wall by the pleural effusion. How so large a cancerous 
mass could be developed, and yet there be an absence of cancerous 
cachexia, I cannot understand. The microscope fully confirmed what 
was so apparent. The walls of the heart, which were also examined 
and found hypertrophied, seemed to contain cysts of the same material, 
varying from a millet seed to a large pea. A division of its wall 
showed the same material in its substance. The kidneys presented a 
like appearance, and were the finest specimen of large encysted 
kidneys I have ever seen. Many of the cysts seemed to contain only 
an albuminous fluid, while others contained a fatty substance ; not a 
few being as large as a hickory-nut. 

Paracentesis would have prolonged his suffering, but given only 
temporary relief. This case is reported only for its pathological in- 
terest and family history. His grandfather, Aaron Reed, or rather his 
wife, had five boys and seven girls ; of these, three boys, John A., Aaron 
and Jonathan, have died from cancer. Dr. Vought attended Aaron, 
and Dr. Thomason attended John and Jonathan. Four of their children 
(and grand- children of Aaron) have also died of the same disease — 
Daniel, son of Jonathan ; Joseph, son of John ; Emeline, daughter of 
Jonathan, and James, son of Aaron, whose case is herein so fully de- 


tailed There is a large number of grand-children living yet, whose 
ages range from twenty to forty, and should any of them ever come 
under your supervision with an obscurity of symptoms, with ^is 
history before you, you may remember, "By their fruiU ye shall 
know them." 
Eatoktowh, May, 1876. 

The Microscope in Medical Jurisprudence. 


During the recent trial in our County Courts of Mary Ganley, for 
the murder of her husband, a club was offered in evidence. Upon 
this club were blood-stains and a small tuft of short black and white 
hair. By the prosecution it was claimed that that club was the 
instrument with which the injuries on the head (which were the 
cause of death) were inflicted, and that the blood was human blood, 
and that the hair was human hair. By the defence it was claimed 
that the blood was the blood of a fowl, which might have easily got 
on the club at the wood-pile, where a few days previous to the homi- 
cide, a number of chickens had been killed, and that the tuft of hair 
was not hair, but black and white wool which had been carded in the 
house a few days previous to the man's death, and might have been 
swept out and adhered to the club while wet with chicken's blood. 

As the testimony upon the nature of the stains and hair upon this 
club was considered important in its bearings on the case, I was 
asked by the prosecuting attorney to determine their character by scien- 
tific tests. 

Upon making an examination of the club, a crack was opened and 
from it a few scales of dried blood were scraped. A small scale the 
size of a grain of sand, was placed upon a glass slide and over it a 
thin glass cover was pressed with sufficient force to reduce the scale 
to powder. The slide was then placed on the stage of the microscope 
and accurately focused under a one-twelfth of an inch immersion 
lens, the magnifying power of which is about seven hundred and fifty 
diameters. A drop of clear water was then allowed to insinuate itself 
between the two slips of glass. In a few minutes the powder absorbed 
the water, and by adding a few drops more, hundreds of globules 
were distinguished from the mass, and floated out clearly into view 


Some of these globules shriyeled and rolled, but many of them were 
circular and without a nucleus, thus showing conclusively that the 
blood was animal blood and not that of a fowl. In order to verify 
the results obtained by this examination, some of the scales of blood 
taken from the same crack were placed in a test-tube and macerated 
over night in a solution of sulphate of potash. Upon subjecting the 
dark colored fluid obtained by the maceration to a microscopical 
investigation, the circular globules were again detected. 

Upon making a further and close inspection of the club, three 
fragments of hair from a half an inch to an inch in length were found 
entirely distinct in their location from the tuft of hair before men- 
tioned. Upon placing these hairs under a quarter-inch objective 
they were distinctly shown to be human hairs, and one of them had 
the roots and the hair follicle in which it grew attached, thus show- 
ing that it had been pulled from the head. A few hairs having been 
removed from " the tuft " and subjected to examination, were found 
to be cat's hair and not wool, as was claimed by the defence. 

The frequency with which we as medical men are called upon to 
testify as experts in courts of justice, and the frequency with which in 
these days the microscope is used as a means of determining the guilt or 
innocence of the accused, leads me to call attention for a few moments 
to its uses in the investigation of crime, and to the position it occupies 
in medical jurisprudence. 

Many interesting cases might be cited to prove its value in recogniz- 
ing blood-stains upon weapons used or clothing worn during the 
infliction of murderous wounds ; but a few will serve for illustration, 
and for that purpose I have selected cases with which most of you are 
pr9bably familiar, in some of their details at least. 

About a year ago in the adjoining county of Middlesex, a man by 
the name of Sullivan was tried for the murder of a farmer, by the 
name of Talmage. In this instance, no one saw the deed committed, 
but circumstantial evidence pointed to the man Sullivan as the mur- 
derer. He was arrested, and on his clothing dark stains were found. 
These stained garments, together with a club found near the place 
where the murder was committed, were given to Prof. Vandyke, of 
Rutgers College, for analysis. Prof. Vandyke removed the stains 
and submitted them to microscopical examination, and at the trial 
testified that they were produced by human blood. During the trial 
it was proved by the defence, that the blood on the garments was the 


result of a wound in the prisoner's arm, receiyed in an affray previous 
to the murder, but the blood on the club could not be so easily 
accounted for. The prisoner was conyicted and hung. 

A few months ago (at the same time that Mary Ganley was being 
tried in our courts) a man by the name of Reubenstein was tried in 
Brooklyn, for the murder of Sara Alexander. 

During the trial. Prof. Eaton, a distinguished microscopist, testified 
that he had examined stains found on the boots of the prisoner, and 
found them to be blood. That in the dirt on his boots, he had dis- 
covered a small chip about the tenth of an inch ^ of an inch) long, 
which he submitted to microscopical examination, and found to be 
corn husk, and that he also found a fragment of woolen yarn which 
was similar in texture to that in a shawl which was worn by the girl 
at the time of the murder. As the murder was committed' in a com 
field, the presence of corn husk in the dirt on his boots was very im- 
portant testimony against the accused, who was conyicted of the 
murder and sentenced to be hung. 

A few years ago there occurred in Norwich, England, the following 
case : (Vid. Wharton and Stille's Medical Jurisprudence). " A female 
child, nine years old, was found lying on the ground, in a small plant- 
ation, quite dead, with a large and deep gash in the throat. Suspi- 
cion fell upon the mother of the murdered girl, who,'upon being taken 
into custody, behaved with the utmost coolness, and admitted haying 
taken her child to the plantation where the body was found, whence 
the child was lost by getting separated from her while in quest of 
flowers. Upon being searched, there was found in the woman's pos- 
session a large and sharp knife, which was at once subjected to minute 
and careful examination. Nothing, however, was found upon it, 
with the exception of a fine piece of hair adhering to the handle, so 
exceedingly small as to be scarcely visible. The examination being con- 
ducted in presence of the prisoner, and the ofiicer remarking ; *' Here is 
a bit of fur or hair upon the handle of your knife," the woman imme- 
diately replied, ^' Yes, I dare say there is, and very likely some stains 
of blood, for as I came home, I found a rabbit caught in a snare, and 
cut its throat with the knife." The knife was sent to London, and 
with the particles of hair, subjected to a microscopic examination. 
No trace of blood could at first be detected upon the weapon, which 
appeared to have been washed ; but upon separating the horn handle 
from its iron lining, it was found that between the two, a fluid had 


penetrated, which proved to be blood— certainly not the blood of a 
rabbit, but bearing every resemblance to that of the human body. 
The hair wag then submitted to an examination. Without knowing 
any of the f«cts of the case, the microscopist immediately declared 
the hair to be that of a squirrel. Now around the neck of the child, 
at the time the murder, was a tippet, over which the knife, by whom- 
so ever held, must have glided ; and this tippet was EquirrePs fur. 
The woman was convicted, and while awaiting execution, confessed 
her crime." 

Nearly twenty years ago, Dr. Burdell of New York was murdered 
in his room. In searching the house after the murder, for a clue to 
the perpetrator, a bloody towel was found in the closet of one the 
gentlemen boarders. Upon being unable to account for it he was 
arrested. Soon after the arrest, a lady living in the house, went to 
the police and told the following story : She said that she was men- 
struating at the time of the murder, and in going up stairs her napkin 
fell off. The house being full of people, and she being embarrassed 
at her misfortune, rushed into the first open door that presented itself, 
to readjust the necessary garment. Being interrupted before she 
could do so, she threw the napkin in the closet, intending to return 
for it at a more favorable opportunity. Before she could secure it, 
it was found by the police, and, as before stated, the owner of the 
room was arrested. In order to test the truth of the story, the towel 
was submitted to a microscopist for examination, and the blood on it 
was found to be freely mingled with epithelium from the uterus, thus 
clearly showing it to be the menstrual blood. Upon this testimony 
the gentleman was released from custody. 

In Taylor's Medical Jurisprudence a case is cited where some cotton 
fibres detected by the microscope on the edge of a razor, showed that 
the weapon had cut through the strings of a cotton night cap, in giv- 
ing a fatal wound on the neck ; and finally another case is cited in 
which an assassin was detected and convicted partly upon the indica- 
tory evidence furnished by a lock of hair remaining firmly grasped in 
the hand of the murdered man. The hair under the microscope 
resembled, in all its physical character, that of the prisoner; the indi- 
vidual hairs were found to be some of them broken, others torn out 
by the root, and others cut, and on the prisoner's head a bare place 
was found to which they corresponded. 

The cases I have cited clearly illustrate some of the methods in 


which the microscope has been applied in the investigation of crime. 

In testifying upon the witness-stand with reference to blood stains, 
we are certain to be asked what kind of blood have you discovered ? 
In answer we can say positively whether it is derived fiDm the mam- 
malia, or from birds, reptiles or fish ; but can we go further and say 
whether it be animal or human blood ? 

Dr. Richardson, microscopist to the Pennsylvania]^ Hospital, in an 
article on ^^ the value of high powers in the diagnosis of blood stains," 
(published in the American Journal of Medical Sciences, July, 1874,) 
affirms the possibility of distinguishing the blood of man from that of 
certain domestic animals, (citing that of the pig, ox, red deer, cat, 
horse, sheep and goat,) by the difference in the size of the globules. 

Dr. Woodward, of the Army Medical Museum, in Washington, than 
whom I believe there is no better authority upon this subject, in a pa- 
per published in the American Journal of Medical Sciences, for Jan- 
uary, 1S75, reviews Dr. Richardson^s article, and says in substance, 
that as the subject is one that from'time to time becomes of great im- 
portance in criminal cases, justice no less than scientific accuracy, 
demands that the microscopist, when employed as an expert, shall not 
preteod to a certainty which he does not possess. That although an 
experienced microscopist is not likely to be misled, yet that there are 
many physicians who work with the microscope more or less, to whom 
a partial statement of facts on such a subject as this is peculiarly dan- 
gerous. If Dr. Richardson^s statement of the case is true, it is not the 
whole truth, for there are certain animals, among them the dog, 
whose red corpuscles are so nearly identical in size with those of hu- 
man blood that they can not be distinguished with any power of the 
micfoscope even in fresh blood, much less in dried stains ; consequent- 
ly, it is never in the power of the microscopist to afiirm truthfully on 
the strength of a microscopic investigation that a given stain is posi- 
tively composed of human blood and could not have been derived 
from the blood of any animal but man. 

Mr. Gulliver, a distinguished English microscopist, says " that in 
monkeys, seals, otters and dogs, the corpuscles are about as large as in 

In Wharton and Stille's Medical Jurisprudence, (Vol. 2, Part 2 — 
1873,) the cl^aracteristics by which the blood of mammals is distin- 
guished from that of birds, reptiles and fishes having been described, 
it is thus stated : " The globules in all the mammalia (with the excep- 


tion of the camelidse) are so nearly alike in size and other charaeten - 
to those of man, that practically no distinction can be made." " Thus, 
the blood of an ox or sheep cannot by the microscope be, for medico- 
legal application, distinguished from that of a human being, for 
although the globules are somewhat smaller than those of human 
blood, yet the size of the globule in the human blood varies according 
to whether it is fresh or dried, and the difference between its size in 
man and animals is too slight to be made a point in evidence in oases 
where such momentous consequences may depend upon the decision." 

With reference to the time after the effusion of blood at which the 
globules can be recognized, Dr. Taylor says ^^ he has obtained clear 
evidence of their existence in, and separation from, a minute fragment 
of dry blood which had been kept in a dried state for a period of 
three years." " M. Robin detected them in spots from eight to twelve 
years old. But such certainty cannot be expected if the spots have 
been washed, or if while fresh, they have undergone putrefaction." 

An additional proof of the presence of blood is derived from cer- 
tain microscopical crystals which it contains. As these crystals can be 
obtained fron^ all kinds of blood they are of value only in proving that 
the fluid or stain is blood. 

The spectrum microscope has also been made use of in the examina- 
tion of blood, and with it there seems to be no great difficulty in 
recognizing its presence or absence, but its source can not be deter- 
mined by this means. 

Such I believe is the present position of the microscope in medico- 
legal cases ; and it seems to me that medical men, who at any time 
may be called upon as experts to testify in our courts of justice, should 
be familiar with its true position, lest society should run more risks 
from the scientific expert than from the criminal he is called upon 
to convict. 

Fbeehold, May, 1876. 

Membranous Enteritis. 


It would seem the human system, compassing such small extent^ 
and brooded over for ages by medical philosophers, should some time 
ago have yielded up its secrets to the sages. But whether it is that 
the anatomy passing through certain cycles bears with it germs that 



appear and disappear, develop at one time, and at another seem to 
pass away, certain it is its etiology is never long to be depended upon. 
Diseases of the same nomenclature suddenly assume new forms, and 
demand new modes of treatment. Weapons of our art, laid upon the 
shelf by the past generation, are taken down again by this, and those 
bequeathed to us we somehow find useless in the battle against disease, 
and throw them with the lumber and dust of a past age. Mercury 
and the lancet, now some years abandoned to reproach, begin to be 
championed forth again, and their merits discussed in public places. * 
Dr. Hartt, of New York, read a remarkable paper on the " Decadence 
of Medicine," before one of the Medical Societies of that city, during 
the past winter, and strongly urged the return to old modes of treat- 
ment in vogue half a century ago ; and at the late meeting of the 
American Medical Association, Dr. Samuel D. Gross, in a paper read 
before that assembly, took strong grounds in advocacy of blood-letting 
in the early stages of inflammatory diseases, and was received with 
great applause. 

So it is; what we think fast ground gives way beneath our feet, 
but it is not that science crumbles, it is that our little day is too short 
for us to comprehend the laws of change that govern it. It is only 
when we compile the experience and observations of all the genera- 
tions, that fleeting time can compass the length bf art. As Goethe 

' ' Vain is it that our science sweeps the skies — 
Each, after all, learns only what he can ; 
Who grasps the moment as it flies, 
He is the real man.'' 

But it may be argued of this generation of medical scientists, that 
the causes of disease are more closely scrutinized and sought for, 
than at any time before in the history of men. Symptoms are class- 
ified, and differences more clearly apprehended, confusion is avoided, 
and dtill the good work goes on. 

A disease that Dr. DaCosta designates as membranous enteritis, 
has been, till within the last decade, confounded with dyspepsia, 
diarrhoea, dysentery, and even the presence of intestinal worms. It is 
eharacterized, as I have found it in my own experience, by soreness 
and tenderness in the region of the small intestine, wi:h paroxysms of 
intense neuralgic pain, and the passage of strips of membrane from 
the rectum, after which there is comparative- comfort for a few days, 


when the neuralgia returns, and the same process is again completed, 
and so on. 

It is cf this disease I wish to treat, as briefly as possible, and illus- 
trate with the clinical history of a most complicated case in my own 

So far as I know, Dr. DaCosta is the flrst writer who has dealt 
with this affection as a separate disease. Others have considered it as 
a freak of some inflammatory process, or at the best, aa the excessive 
* symptom of some other complaint. Kaempf speaks of it as infarctus ; 
Good as diarrhea tubularis ; Todd as follicular colonic dyspepsia ; 
Cruv^lhier apd LaboulbSne as pseudo-membvanous enteritis; Powell 
as painful affeotion of the intestinal canal ; Whitehead and Eustace 
Smith as mucous disease; Clemens as intestinal croup; Ball6ux as 
dysentery, and Lipsius as worms. 

Anatomical Character, — Membranous enteritis has been so recently 
studied, that its anatomical character can only be surmised, not 
positively declared ; since, though an agonizing affection, ^t has a 
tendency to become chronic, and death from it alone must be ygcj 

The small intestine is composed of three coats, serous, muscular and 
mucous. The muscular coat consists of two layers, the outer arranged 
longitudinally, the inner disposed transversely, which makes it of a 
dense and unyielding texture ; over this lies the mucous coat, the sur- 
face of which is greatly extended by being formed in transverse folds. 
A statement of this fact will readily admit the conclusion that in any 
inflammatory condition of the enteric canal, a serous effusion occurring 
between the mucous and muscular coats would detach the latter from 
the former, and if the inflammation be long continued, death of the 
mucous coat in portions must occur, and these be cast off by the 
natural movements of the bowels. Then a raw surface left, if indeed 
a new mucous coat be not already in process of formation, and suffi- 
ciently produced to cover the muscular coat from observation. For, 
in post-mortem examinations of the intestine affeeted with acute 
enteritis, the peyerian and solitary glands have always been found 
unaffected, and these should act as nuclei for the new mucous cells to 
gather about ; besides, in detachment of strips of some length, process 
of repair must begin at once, here as well as in the fauces when diph- 
theritic membrane is cast off. I only offer this as my opinion after a 


careful study of the clinical history from observation, as I have seen 
none recorded. 

Clinical History, — ^The local symptoms, as I have before observed, 
are pain and soreness in the region of the small intestine, attended 
with painful exacerbations, and discharge of membranous strips, 
occurring at intervals of longer or shorter duration ; generally four 
weeks. The clinical history of a case I have now under treatment, 
will illustrate #fte disease in all of its phases. 

Miss L. is a lady of more than ordinary intelligence, fitted by nature 
to shine in society, and as it is, the favorite of a large circle of friends 
and acquaintances, though unfortunate circumstances of disease have 
confined her to her room for nearly seventeen years. Hers has been 
a long and melancholy history of hope deferred, and of old age 
descending upon a life cheated of its youth and the wholesome 
pleasures of its kind. 

To begin at the beginning, her menses were suppressed upon their 
first appearance by injudicious sea-bathing, and did not appear again 
for ten months. Afterwards they were never regular, appearing at 
intervals of five or six weeks, and longer. Frequently they would be 
suppressed for months. Intense pain characterized their appearance. 
LeucorrhoBa was a prominent symptom for several years. 

In 1835, there appears to have been an infiammatory condition of 
several of the important organs. Her eyes were affected to such a 
degree that sight was misery; her throat became affected, I would 
judge from her account, with sub-acute laryngitis, which has continued 
ever since ; the liver was congested, and the kidneys gave* off large 
deposits of uric acid. About this time she began to feel soreness and 
pain of the bowels, but no membranes were ejected until 1843. 

A liberal course of mercury and depletion by blood-letting, was 
begun by her medical attendant, and not given over, though the 
majority of the symptoms persisted and her health grew worse. 
During 1836-7 she was ptyalized three times, and the pain in her 
bowels was increased, and she suffered much from neuralgia. 

In 1843 she was again placed under heroic treatment, by another 
physician, and was ptyalized twice during this year; but this cam- 
paign left her worse off than before, as the pains in the abdomen 
culminated in the discharge of mucous strips or membranes from the 
rectum. This was looked upon as a form of dysentery, and treated 
as such. But the membranous enteritis persisted, and pieces of mem- 


brane continued to be discharged at intervals of about four weeks. 
The pain at such times was well nigh intolerable, though a compara- 
tive ease of a few days would intervene between the paroxysms. 

In 1861 she was again placed under the influence of mercury, when 
she took to her bed entirely, and has scarcely ever left it more than a 
few hours at a time, since. About this time she passed a strip of 
mucous, tubular in form, twenty inches in length, she says, and it 
appears her physician confirmed it. This was after an unusually severe 
paroxysm. When these strips were longest, the attacks of neuralgia 
were prolonged for several days, and small pieces of mucous kept pass- 
ing from the bowels, until the long strips of membrane were ejected, 
when the pains remitted. 

There never seemed to be any association between the menstrual 
difficulties and these colicky pains, as they scarcely ever occurred 
together; and if they did, the abdominal pain did not seem to be 
heightened. Her physicians do not appear to have ever examined or 
to have taken much note of these membranous discharges. 

During all those years she appears to have run the gauntlet between 
long files of all the medicines of the dispensatory, and received a 
malicious stroke from every one of them, until she became the despair 
and reproach of the profession on her side of the county. But for all 
that, though in almost daily agony, she has outlived some ten or 
eleven of her medical advisers, and holds them as saints in her calen- 
dar ; such devotion does long-suffiering breed I 

I first saw this lady in February, 1874, in consultation with Dr. 
Herbert. He was treating her for retrovecsion of the uterus. There 
was a marked retroversion with retro-lateroflexion of the uterus. She 
was unable to walk more than a few steps, and that with painful 
effort. There was such exquisite tenderness of the mucous coat of 
the vagina, that she could not endure the presence of a pessary, how-: 
ever carefully adjusted, for more than six or twelve hours, when its 
impress would be left in purple. However, by the frequent use of a 
uterine replacer, followed by carbonized cotton pledgets, she grew 
much better of the retroversion, so th&t a sound would enter the 
uterus without being bent. About this time she was attacked with 
vaginitis of such an angry character, that uterine treatment had to be 
suspended. Upon inquiry I found she had been subject to such 
attacks before, when no uterine treatment was used or thought of. 

She became my patient in March of that year, her physician remo^ 


ing to San Domingo. Pretty soon after I took charge, she began to 
complain of great pain in the abdomen, when I, being unacquainted 
with much of her previous history, suspected the uterine treatment to 
be the cause, and left it off at once, prescribing hydrate of chloral as an 
anodyne, but she did not get much better until the periodical discharge 
of the membrane, though I was not then acquainted with the reason. 

In April there was another attack, exceeding in violence any she 
had had for several months. I found it necessary to use the hypo- 
dermic syringe almost daily for a while, to control the paroxysms. 
These ceased gradually, to begin again in June, and so it has been 
almost monthly, until within the last three or four months, when I ' 
perceive the attacks occur at longer intervals, with pain less acute and 
membranous discharges slighter. How long even this partial good 
fortune will last I will not venture an opinion. 

I first begun to examine these pieces of membrane last summer, and 
in October and November obtained a cftst thirteen inches in length. 
I concluded, from tests and examinations I made, that they were from 
the mucous coat of the small intestine, as well from their size as that 
Miss L. always complained of most pain and soreness in tne viscera 
below and beneath the stomach. It was not until I read an article 
in the January number of the American Journal of Medical Sciences, 
on^ Membranous Enteritis, by Dr. Findley, that I begun to feel satisfied 
with my conclusions, or the treatment I was pursuing. Last week I 
obtained from Philadelphia, Dr. DaCosta's monograph, on the same 
subject, wherein I found the only plain account of this dreadful dis- 
ease that I have yet seen in print. 

There are a few other symptoms in Miss L.'s case I wish to detail, 
before entering into an analysis of the fj^w cases on record. She has 
always sick stomach for two or three days before these membranous 
casts are excluded. No blood passes at any time. She has long been 
troubled with dyspepsia and want of appetite. Coldness of the sur- 
face every morning, seldom any fever. Occasionally the urine deposits 
gj^eat quantities of uric acid. If she loses fiesh during an attack she 
soon regains it. Is very nervous, but never hysterical. 

From idiosyncrasy cannot endure any anodynes but chloral hydrate, 
and fiuid ext. of Indian hemp. Is naturally disposed to be constipat- 
ed, but dejections easily occur upon use of teaspoonfal doses of 
Rochelle salts. 

An analysis of eleven cases gives the following results : 



























11 years. 

Irritation of 



Ulceration of 



M. G. 



14 " 


Kitratdof Sil. 



81 »* 



M. C. 




6 mo. 

Conges, liy. 







2 years. 

Prep, of Iron. 





2 " 



Ulc. OS and 


cerv. ut. 



D. G. 



18 mo. 

Uter. irri. 




. " 

21 E. W. 



9 » 


Liq. fer. iodi. 


25 L. 



32 years. 


and latero flex 

Pathology, — Dr. Hare, pathological chemist at the Pa. hospital, has 
analyzed several specimens. They do not dissolve in water. Dissolv- 
ed in caustic potassa, they give a faint precipitate by addition of either 
acetic or tannic acid. I cannot follow his analysis at length, but his 
conclusions are that most of the casts he examined were composed of 
mucus ; qne or two contained a trace of albumen ; they contained no 

Causation. — In two of the cases I have analyzed, mercury seemed to 
have been the controlling cause of the difficulty. Grantham consid- 
ered the disease caused invariably by mercury, conjoined with the 
constant use of aperients. A writer in the London Lancet, Oct. 15, 
1869, asking for information, speaks of two cases which he attributes 
to the same cause. Two of the cases I have analyzed appeared to 
have been caused, by transmitted irritation from the womb, and one 
from congestion of the liver. But DaCosta thinks constitutional de- 
fect is the cause in a majority of cases. 

DiagnosU, — The diagnosis may be generally considered easy, if the 
symptoms are borne in mind and the dejections examined. Tender- 
derness about the epigastrium, neuralgic paroxysms, passage of mucous 
strips unattended with blood, comparative comfort for several days or 
weeks. No other disease presents all these characteristics. 

Prognosis. — The prognosis is unfavorable so far as complete recovery 
is concerned ; though a person may be ill of this disease, suffering a 
, thousand tortures, and live to a comparative old age. Recent cases, 
properly appreciated and treated, are more likely to recover. Where 
the disease is misunderstood it is likely to run into the chronic stage 
and persist for years, or during the lifetime of the {>atient Nor does 


it always yield when early seen, to modes of treatment saccessfal, or 
partially so, in other cases, bat recurs again and again until it seems 
impossible to eradicate it 

Treatment. — Daring the exacerbation, anodynes, and powerful ones, 
are called for. In the case of Miss W. I have used hypodermic injec- 
tions of morphine and atropia, one fourth of a grain of one, and the 
ninety-sixth of a grain of the other, thrice in one hour. Deep injec- 
tions of chloroform may be tried with advantage. Counter-irritation 
in some form constantly is advisable. Tonics and alteratives best suit 
the necessities of the case, though they must be continued for a long 
time, and as persistently as the disease. Arsenic is recommended by 
Findley, and appears to have been curative in two of his cases. The 
iodide of iron has the credit in the third. DaCosta cured one case 
in which diarrhea was a constant symptom, by the use of the nitrate 
of silver ; and the different preparations of iron were effectual in 
another. Gentian, the per-chloride of iron, cod-liver oil, the acids, 
nux vomica, copaiba, pitch-pills, tar, bismuth, opium, bromide of 
potassium, and electricity have all been highly recommended and dis- 
carded, and tried again. Nutritious diet, and moderate exercise when 
possible, should always be insisted upon. And whosoever cures a case 
should straightway report it, for the lists will be long open. 

Kbypobt, May 17th, 1875. 

The Relationship between Typhus Fever anb 

Cerebro-Spinal Meningitis. 


A case of sporadic cerebro spinal meningitis, now under my care, 
presenting very singularly marked features, has set me to thinking of 
the common relationship of eruptive fevers, but more particularly of 
cerebro-spinal meningitis and. typhus fever. 

My patient, Henry Walling, a lad of fourteen years, was attacked, 
Sept. 4tb, by what an itinerant quack, who was called in, diagnosed 
as " a cold," but concluded was the " lockjaw," four days afterward, 
when he was discharged. I found the lad with all the symptoms of 
sporadic cerebro-spinal meningitis aggravated to an extreme degree. 
His surroundings were vile and unfortunate and there was everything 
to provoke a speedy dissolution. The room was small, ill-ventilated, 


and reeking with odors. The bed on which he lay wac^fonl and nar- 
row, and the walls grimy with the steam of many indigestible dinners 
and late carousal with gossips. The very water they drank, I learned, 
was infected with the decay of woody fibre, if not worse. The third 
day after my visit, in a spasm of confidence, I was shown the parietal 
bones of the skeleton of an infant that had been found under the floor. 
Death had left his signet with the house I The tonic spasms with 
opisthotonos, and the spinal pain, yielded their severity to large doses 
of chloral and quinine. 

On the second day of my attendance, and the sixth of the disease, 
lumbricoid worms began to be expelled from the intestines, and so 
continued to be, at intervals, until thirteen had been passed. The 
characteristic eruption did not appear until the tenth day of the 
attack, when the body and extremities were covered with dull purple 
spots, which remained in this condition until last Thursday, Sept. 30th, 
when they assumed a bright crimson appearance, were raised, assumed 
crescentic forms in places, became confluent on the face, chest, about the 
genital organs and on the feet and legs. On Friday the face and eye- 
lids and the feet became cedematous. On Sunday morning the bright 
redness of the eruption had departed in a great measure, and this 
(Monday) morning, except in places, all was a dull purple and sunken 
to the skin level. 

During all this while there was no increase of temperature or ner- 
vous excitement, nor any fresh internal lesion to be discovered. 

I wish to call attention to the fact that this abnormal increase 
of the eruption was raised above the surrounding surface, was unin- 
fluenced by pressure, was confluent in situations, crescentic at times, 
in other places round and red petechias. 

Searching for authority in such unusual occurrence, I received but 
scanty reward for my pains. Da Costa says only in extremely rare 
instances is the rash rose-colored. Tourdes states that a rose-colored 
papular eruption, like that in typhoid fever, is occasionally observed. 
Flint believes the petechise due to extravasation of hematin, and, if so, 
the color is likely to be crimson if the symptoms be sufficiently grave. 

A communication in the ^' Transactions of the N. J. Med. Soc. for 
1873," from a medical gentleman in Gloucester County, whose name 
does not occur among the list of members, details a series of cases of 
what he is pleased to call " cerebro-spinal meningitis accompanying 
measles." In the same family he had patients with cerebro-spinal 


meningitis coyered with an eruption resembling yaricella, that disap- 
peared in three days ; afterward an eruption appearing on the same 
patients resembling measles that began to recede two days afterward. 
Whether the petechia wholly disappeared or persisted in modified 
form during the disease he does not say ; but while these notes are 
not complete, they are unique. Says one of them : " Eupheme and 
Adaline about the same. Eupheme's head further back, and spine 
and extremities bad." He says his treatment consisted of every item 
of the materia medica that suggested itself to him, and he even 
thought of using the battery on Eupheme, but she judiciously died 
before the experiment could be made. As the eruption of varicella 
ordinarily awaits the fifth day before dessication, and as the eruption 
of rubeola disappears on the fourth day, I conclude the doctor's cases 
were complicated with neither of these eruptions, but that the pete- 
chisB he observed were modified forms of the usual eruption of cerebro- 
spinal meningitis, and to some extent resembled that in my own case. 
Dr. Wood states the petechise often resemble those of typhoid fever, 
and these Louis defines to be of a lenticular rose-colored character. 
And that brings me back again to Flint and Tourdes. An excursion 
into polite literature gives me the following, from Boccaccio's intro- 
duction to his DecameroD : '^ In the year of our Lord 1848, there hap- 
pened at Florence, the finest city in all Italy, a most terrible plague ; 
which, whether owing to the influence of the planets, or whether it 
was sent from Qod as a just punishment for our sins, had broken out 
some years before in the Levant, and after passing from place to place, 
and making incredible havoc all the way, had now reached the West. 
Unlike what had been seen in the East, where bleeding from the nose 
is the fatal prognostic, here there appeared certain * tumors in the 
groin or under the armpits ; and afterwards purple spots in most parts 
of the body ; in some cases large and but few in number, in others 
smaller but more numerous — both sorts the usual messengers of death." 
In 1872, some farmers in the neighborhood of Wyoming, Delaware, 
where I was then practicing, sent an agent to Sweden, who induced 
the emigration of about eighty of the peasantry to the home of his 
associates. Upon their arrival they were all housed in a large barrack 
until they could be parcelled out to their future employers. As low 
and filthy a set of beings could not be found outside of the ancient 
splendor of Europe. A few days after their arrival a disease broke 
out among them, characterized by fever and eruption, that rapidly 


proved fatal. Aa a medical man was likely to be in constant service 
for awhile, like a prudent corporation they sought the cheapest. An 
illegal practitioner was called in, who puzzled himself over the cases 
for two or three days, and ended by calling them small-pox, and treat- 
ed them as such ; but the mortality persisted, and the farmers were 
fain to call in regular physicians, who found the cases to be of typhus 
fever. I did not see any of the patients, but Drs. Jump, of Dover, 
and Sharp, of Camden, said the petechise resembled those of aggravat- 
ed cerebro-splnal meningitis, while the fever was of a typhus nature, 
and most of the cases recovered in fourteen days under the new treat, 
ment, though some lingered for weeks. 

That there was a common origin here for differing phases of the 
same disease, as there is again and again in ether cases, is difficult to 
be set aside. The same disease in the same person, as in my case, will 
present the phases of two or three recognized diseases, and seen by 
different physicians at different times would go far toward deceiving 
the very elect. That the plague described by Boccaccio, which he 
does at great length, was a modified form of typhus, I verily believe ; 
and that typhus and cerebro-spinal miningitis may be due to the 
same cause, I as readily consent. Both occur among the ill-fed, the 
ill-clad, the ill-lodged, in a proportion under the same circumstances. 
MurchisoD, in his treatise on Continued Fevers, gives abundant in- 
stances of typhus fever occurring in jails, hospitals, workhouses, ships, 
and unventilated tenement houses crammed with occupants. In 1841, 
Flint reported four cases occurring in the Erie County almshouse, in 
a small and crowded ward, heated and unventilated. The epidemic 
of cerebro-spinal meningitis occurring in the South of France, in 1887, 
attacked prefer&bly the garrisoned towns. An epidemic of it in Ire- 
land raged fearfully among the miserable tenantry of the low and 
boggy districts. Bondin has identified this disease, as it occurred in 
France, with typhus fever, from the most ordinary forms of which it 
differs only in the seat of lesion. He believes it contagious, since he 
could in no other way account for its tendency to attack crowded de- 
pots and garrisons. Says Wood : " I have little doubt that wherever 
it occurs as an epidemic, presenting grave characters, it is in fact a 
form of malignant fever, belonging to the group of typhus diseases, 
and bearing a close analogy in general character to the typhus epi- 
demic which prevailed in the United States in 1812, and for yean 
afterward.'' Says Da Costa : " While fully admitting that we can not, 


from the eyidence in our poMeasion, as yet decide with certainty on 
spotted feyer being merely modified typhus, and developed by the 
same poison, a larger experience with the disease than I had in 1864, 
when I first wrote upon it, makes me adhere still more decidedly to 
the opinion that it is not an inflammation but a fever of a typhus 
kind, kindred, to say the least, to typhus fever. 

In a note appended to the page I have quoted from, the same author 
states that the blood rapidly deteriorates in cerebro-spinal meningitis. 
In the autopsy of a child, who died in twenty-four hours, he found the 
blood difiluent and black ; in an adult patient, sick but two days, he 
detected blowing sounds in the heart, evidently of blood origin. And 
he adds "that the poisoned blood unquestionably gives rise to many 
of the nervous symptoms, and it is upon the blood and the nervous 
centres the poison mainly acts. In this respect the malady is very 
like typhus fever." 

The subjoined table shows the similarities and dissimilarities of the 
anatomical Itoions : 

Cebebbo-Spikal MENnroins. Typhdb Fsyeb. 

Serous effasion, and sometimes puru- Heart often flabby and softened, 
lent liquid found in the pleural and 
pericardial cavities, in the joints, and in 
the tunica vaginalis. 

Deteriorated condition of the blood. Blood dark and fluid. 

Spleen enlarged. Spleen enlarged. 

Foyer's glands and follicles of Brun- Peyerian glands more distinct than 
ner abnormally distinct. usual, having a '* shaven beard ap- 


Absence of lymph and pus, and all in- Congestion and efl^ision not uncom- 
flammatory product in a certain proper- mon, but unattended with lymph, 
tion of cases. 

In some cases cerebral meningitis Cerebral congestion not uncommon, 

Fatty degeneration of the kidneys Kidneys are apt to be congested; 
and liver. sometimes enlarged, and convoluted 

tubes may be filled with desquamated 

In majority of cases surface of brain In 1847-8 Prof. Alonzo Clark observed 

and spinal cord covered with exudation appearances denoting meningitis, 

of lymph, chiefly beneath the arachnoid Effusion of serum into the ventricles 

membrane and extending into the sluice of the brain, the subarachnoid space, 

between the convolutions. and the arachnoid cavity, 


Thus it will be seen how nearly alike are the anatoviical lesions of 
these diseases, and where one outyies the remains of the other. What 
is it bat the fatal opulence of a more enterprising phase of the same 
disease ? 

Kktport, Oct. 4th, 1875. 


To Chairman of Standing Oommittee^ &c. : 

With a view to eliciting a response from every mem- 
ber, I have made an experiment which has been so 
successfully inaugurated, that I am led to believe that 
it is a step on the way to a method, which, if 'thorougly 
adopted by the other District Societies, cannot fail to 
make our sanitary reports more complete than they 
have heretofore proved to be. Under appropriate 
headings I arranged a series of questions to be an- 
swered. These were printed on letter paper with 
ruled blank spaces under each question for the reply. 
On the first of April a "blank" was sent to each 
member with instructions to " fill it out and return to 
me before the 15th inst." About half of the blanks 
were used and returned within the time specified, and in 
the week that followed many more came. This gave 
me a brief history of the diseases that occurred in 
different parts of the county, with many very interest- 
ing facts in relation to the causes, pathology, treat- 
ment, death-rate, etc., thus proving the possibility of 
a communication from a majority of the members, and 
that too in a systematic form, which facilitates some- 
what the work of the reporter. The cost of printing 
the blanks is but small, and even this could be greatly 
reduced by omitting the dates and having them made 
in quantities sufficient for several years. 


Of the diseases incident to the seasons, there was a 
marked increase, with a corresponding increase of 
mortality through the hot season and during the 
months of February and March. The spring, fall and 
early winter, were generally healthy. We have been 
visited by most of the so-called contagious diseases of 
childhood, which have usually been of a very mild 
type. In three localities only, Rockaway, Boonton 
and Middle Yalley, was the death-rate thereby ma- 
terially altered. In each of these places, during the 
fall, winter or spring, diphtheria prevailed as an 
epidemic. In the vicinity of Rockaway there were 
probably* one hundred and fifty cases; about twelve 
per cent, proved fatal. At Middle Valley there were, 
perhaps, forty cases. Under a particular plan of 
treatment there were no deaths ; while the percentage 
reported from a different method of medication is 
quite large. In another place we will attempt to 
account for the difference in results. At Boonton 
there were about thirty-five cases, of which fully 
twenty per cent, proved fatal. Aside from sporadic 
cases of diphtheria, a few are reported from Pompton, 
Morristown, Mendham and Dover. 

Scarlatina of a mild type has occurred in Morris- 
town, Parsippany, Boonton and Pompton. In the 
latter place and the country north of it, it was quite 

A few cases of pertussis are reported from every 
part of the county except Morristown. It appears 
that this pleasant little city was especially afflicted 
with an epidemic of hooping-cough in the year pre- 
ceding this, so there are left fewer subjects who do 
not possess an immunity from the disease. 

Parotiditis is reported from Mine Hill, Dover, Mend- 


ham, Morristown and Rockaway. In the practice of 
Dr. Ayers, at the latter place, metastasis to the tes- 
ticles was of frequent occurrence. In the case of a 
female the mammae and generative organs were the 
seat of secondary trouble. The breasts were swollen 
and painful, with severe aching pain through the 
pelvis and external organs. Dr. Cummins, of Dover, 
also records a number of cases wherein the testes 
became affected. An epidemic of roseola which com- 
menced at Stanhope, Succasunna and Flanders in the 
north, and western part of the county in the spring of 
'74, slowly migrated east by south, reaching Morris- 
town several months later, where it continued to 
prevail for a considerable time during the past year. 
This rare, yet interesting affection, was characterized 
by scarlet red rash, with or without eruption, with a 
good deal of febrile disturbance. The peculiar sore 
throat of scarlatina, and the pathognomonic cough of 
measles were almost invariably wanting. Not any of 
the cases which came to my notice were accompanied 
or followed by any of the complications or sequelae 
so common with measles and scarlatina ; hence, a 
distinct and separate disease — conjunctivitis — which 
was quite prevalent in Morristown, appeared to assume 
the peculiarities of a contagious disease. 

Our county has been unusually exempt from vario- 
lous disease. Dr. Cooper, of Parsippany, reported a 
case of varioloid, and Dr. Ryerson, of Boonton, one 
of variola ; both recovered. Rubeola or measles has 
prevailed to more or less extent in every part of the 
county except Rockaway, Dover, Port Oram, Mine 
Hill and Succasunna. These places are very near 
each other. A circle with a radius of four miles will 
include them all. This district is thickly populated, 


and within its limits are fifteen practicing physicians. 
The very interesting fact in connection with this sub- 
ject is, that during the fall, winter and spring of '71 
and '72, this district was visited by an epidemic 
of hemorrhagic measles, ''rubeola nigra," "black 
measles," of a malignant type ; very many cases proving 
fatal. The sweep was so thorough and clean, that we 
have since had only sporadic cases. For the past year 
not a single case is reported within this district. It 
would seem that not only the extreme prevalence, but 
the severe form of the disease, has had something to 
do with the comparative immunity we appear to have 
possessed from it for the past four years. 

During the summer and fall, intermittent fevers 
were very abundant at Pompton and Middle Valley. 
At the latter place they were more prevalent in the 
immediate vicinity of the recent excavations for the 
Longwood Valley railroad. Very many of the cases 
assumed a typhoid character. Intermittents were also 
quite prevalent at Succasunna and Parsippany, but 
very scarce at Mine Hill, Port Oram, Rockaway, Mor- 
ristown and Boonton. At the latter place other dis- 
eases have shown a strong tendency to periodicity. 
This phase is described as unusual for that locality. 
They generally yielded to anti-periodic doses of 

During the hot season dysentery was very abundant 
at Parsippany and Mine Hill. Succasunna, Rocka- 
way, Boonton and Dover were favored with about the 
usual amount; while at Middle Valley, Mendham, 
Morristown and Pompton it was less frequent than in 
former years. Cholera infantum was plentiful in Par- 
sippany, Mine Hill, Succasunna and Middle Valley. 
Dr. Farrow, of the latter place, has met with r 


cases than in any year previous. With this marked 
increase of cholera infantum, he says there has been a 
corresponding decrease in the amount of dysentery. 
Cholera morbus has been plentiful in the northern 
central part of the county, particularly among the 
miners in the iron mining localities. In the village 
and vicinity of Rockaway it is estimated that there 
were not less than one hundred and twenty -five cases, 
of which three or four proved fatal. A large propor- 
tion of the cases were among foreigners of the laboring 
classes. This disease has generally been much more 
abundant in the mining localities where the populace 
is largely composed of English and Irish. An exten- 
sive personal acquaintance with this class of people, 
and the disease in question, has convinced me that the 
change of climate is a predisposing, while the change 
in diet is the exciting cause. It is certainly less fre- 
quent among the thoroughly acclimatized, and still 
more scarce with the staid Americans. Crenerally, 
though not always, can the disease be traced to the 
ingestion of large or small quantities of green vegeta- 
bles or unripe fruit. I have repeatedly seen the patient 
vomit a meal which remained undigested, although 
eaten many hours before. A large per cent, of the 
patients retire to bed in usual health ; some time during 
the night the patient is awakened by severe pain in the 
bowels, which soon becomes excruciating. Vomiting 
and purging now begin and often continue until the 
contents, of both stomach and bowels are ejected. 
After this the pain gradually subsides, and in a 
few cases would probably cease without treatment. 
Cramps in the legs, arms and back, often occur when 
the abdominal pain begins "to abate. Fortunately this 
apparently dangerous, yet seldom fatal disease, is a 



self- limited one, and one for which we have a ready 
antidote in the use of morphine. If called to a patient 
before vomiting occurs, or while the stomach is yet in 
an unsettled condition, I invariably give morpliine 
hypodermically. The pain quickly ceases and the 
vomiting and purging also. This has been most suc- 
cessfully followed with opium or calomel in small 
doses ; occasionally alkalies and stimulants are given. 
I have met with not less than ninety (90) cases in the 
past three years, of which not one has proved fatal. 
Dr. Ayers reports very satisfactory results from the 
use of aromatic spts. of ammonia and other alkalies, 
with bismuth and opium. The Doctor seldom resorts 
to sub-outaneous injections of morphine in this disease. 
An epidemic of influenza or catarrh prevailed 
throughout the western part of the county during the 
winter and spring. At Mendham, where it was most 
abundant, it attacked both the old and young ; being 
especially severe with the aged and those possessing a 
low degree of vitality. Other lung troubles were 
unusually plentiful at Middle Valley, Mendham, Par- 
sippany, Boonton, Rockaway and Pompton, and com- 
paratively scarce in other localities. At Morristown, 
during the winter and spring, simple bronchitis was 
rather in excess of former seasons. Dr. Barker thus 
writes of it : ' ' The cory za and cough have been 
generally moderate, while the febrile movement and 
malaise have been marked, and the debility oft<Mi 
extreme." The Doctor believes ''that epidemics 

this character are essentially and primarily 

I have based my treatment on this hypothe 
and Dover's powder, and a careful attention 
alimentation, and often stimulants have se( 
most good." Dr. Romondt, of Pompton, a 


satisfactory results from the free use of quinine in 
bronchitis. The comparative frequency of intermit- 
tent and remittent fevers during the winter and spring 
months has been an object of note with physicians in 
different parts of the county. One physician accounts 
for this excess by "the open winter and verydittle 
snow to cover the decaying vegetation." It h^ ap- 
peared to me that the season was so warm that the 
poison failed to ''freeze up." The history of malaria 
has certainly proved that with the frost and cold 
weather this class of diseases grow exceeding scarce, 
and that a very cold season is often a perfect blessing 
to the chronic "sufferer. 

Simple non-malignant throat troubles were quite 
abundant in Dover during the spring. Dr. Pierson 
has kindly furnished me with the mortuary returns 
for Morristown. They are as follows : total number 
of deaths from April 1st, '75, to April 1st, '76, 151 ; 
from April 1st, '74, to April 1st, '75, 138. The in- 
crease of the past over the preceding year is owing to 
the unusual number of deaths during the months of 
February and March. The other seasons were charac- 
terized by a moderately low degree of mortality. I 
have been unable to procure an authentic report from 
any other place. There has been throughout the 
county about the usual amount of sickness, with a 
proportionate death-rate. 

Therapeutics. — The treatment adopted by Dr. Levi 
Farrow, of Middle Valley, in the epidemic of diph- 
theria, which then prevailed, was briefly this : " Cold 
water and ice to the throat externally ; frequent car- 
bolyzed lime water inhalations ; chlorate potassa for 
patients who could gargle. The most severe case6 
were kept in a room filled with the vapor of boiling 


hot water ; they also almost constantly breathed &om 
a pitcher containing slacking lime, strongly impreg- 
nated with carbolic acid. Caustics and strong astrin- 
gents were not used locally. Internally, tinct. of 
sesqui. chloride of iron and chlorate of potassa, 
quinine, Btilphate of soda, and systematic alimenta- 
tion and stimulation. Out of twenty unmistakable 
oases, five or six of this number, involving the larynx 
and nares, not one proved fatal. With hot applica- 
tions and drinks, and opposite treatment, a neighbor- 
ing practitioner lost one out of three." In view of its 
supposed action. Dr. Bomondt has made use of bella- 
dona as a prophylactic against scarlatina. The result 
was unsatisfactory in every instance. 

Dr. Barker thus writes of salicylic acid: "I use it 
in all contagious and infections diseases ; and for 
nearly two years have nsed it as a prophylactic in 
them all. In no instance has it seemed to fail. In 
other words, when its use has been persisted in, there 
has never been a second case of either diphtheria, scar- 
latina or measles. In a recent instance an unprotected 
gtrl took care of a sister who had scarlatina, and she 
escaped even a sore throat." 

In all inflammatory throat troubles Dr. Owen spealta 
highly of the frequent local application of salycilio 
acid of the following strength : a drachm of the acid 
to three ounces of glycerine. 

Dr. Levi Farrow has used an infusion oJ 
in ulcerated sore throat, with good n 
considers sulphite of soda an adn>'' 
fevers, cholera infantum and contl' 
and bowels characterized bv 
lence, from indigestion. 

In commenting on the alk 


tism, Dr. Carpenter says that he has found that the 
urine can be rendered alkaline more quickly by the 
use of liquor ammonia than by any of the "fixed" 

Dr. Cummins has relied on the sulphate of 
cinchonidia as an anti-spasmodic and tonic, almost to 
the exclusion of sulphate of quinine. 

With Dr. Condict chloral hydrate is a favorite 
remedy as an aiiti-epasmodic, hypnotic and nervine. 

I have used salycilic acid and the salycilate of soda 
as a disinfectant in almost all surgical dressings for 
the past yean It is equal to carbolic acid, and has 
not the disgusting odor which makes that remedy so 
very repulsive. I have also used it in most throat 
troubles, either alone or in combination with chlorate 
of potassa ; in stomatitis, nasal catarrh, and for vaginal 
injections. In combination with three parts of sul- 
phite of soda, it is soluble in fifty parts of cold water. 
A saturated solution possesses very strong disinfectant 
properties. While it is an excellent antiseptic, its 
imperfect solubility and the difficulty of concenti-ation 
will render it inapplicable to some of the \ises to which 
carbolic acid is applied. I have also used Croton 
chloral hydrate in neuralgia, with imperfect success. 

Topical remedies are used by most of our physicians 
in the treatment of malignant sore throat, and are 
generally thought to be valuable adjuvants. Almost 
every means of local application, from the fashionable 
SDrav uroducer to the rmicb Rr>oT\ee swab, are used in 



ta oi 


camphor, carbolic acid, permanganate of potassa, 
tincture of iodine and nitrate of silver. There is a 
decided choice for nnirritating remedies that possess 
strong antiseptic properties. Nitrate of silver and 
other caustics are used with greater caution and doubt 
as to their efficacy. 

About one-third of our physicians use calomel as a 
simple cathartic. One of our leading Doctors, a man 
long in practice, almost invariably produces a calomel 
purge in beginning the treatment of almost all of the 
acute inflammations. He also uses it in engorgement 
of the liver, in the early stages of scarlatina, diph- 
theria, and bUious and remittent fevers. A few of our 
number give it in small doses in combination with 
other remedies in the treatment of cholera morbus, 
cholera infantum and other gas tro -intestinal derange- 
ments. The only morbid conditions in which any of 
our physicians strictly rely upon calomel, are certain 
stages of syphilis, engorgement and torpidity of the 
liver, and as a local application in abrasions of the 
cornea. A large proportion of the physicians in this 
county seldom use calomel for any purpose, while a 
few never administer it. 

P. A. HARRIS, Beparter. 
DoYBB, May 15th, 1876. 

Ununited Fracture of the Tibia, successfully 

treated by exsection after failure to get 

Bony Union by Drilling. 

BY p. A. HABRIS, M. D. 

On the 7th of May, 1875, Samuel Pascor, a healthy Cornish miner, 
set. 28, by direct violence sustained a compound fracture of the tibia 
and fibula, at a point just above the junction of the lower with the 
middle third. Four hours after the injury, patient was anaesthetized. 


the bones reduced, and a plaster of Paris dressing applied, including 
the foot and knee. A large fenestra was cut, at a point corresponding 
with the wound on the inner anterior aspect of the leg. Through 
this, the wound was dressed, and the pus absorbed by a carbolized 
sponge which was kept on the wound. For two weeks the pua 
poured from it in large quantities. The patient complained of but 
slight pain in the limb. Slept well at night without anodynes, and 
took a good generous diet. 

On the 19th of May, the first bandage was removed and a new one 
applied. We then discovered a small opening on the outer anterior 
aspect of the leg, with a sinus leading to the fracture. This, as well 
as the wound, continued to discharge for several weeks. 

On the 19 th of June, the second dressing was removed and a new 
one applied. We allowed this to remain on until the 8th of July, 
nine weeks after the injury. An examination then convinced me that 
the fibula was united, but the tibia very imperfectly. Lifting the 
limb by the foot, caused the leg to bend considerable at the point of 
fractui'e. The opposing ends of the tibia could not be moved on each 
other, and traction sufficient to draw the patient along on the bed, 
failed to show the slightest separation of the fragments. There was 
but slight discharge from the wound. The sinus had closed, and 
probing through the wound gave no signs of detached or necrosed 

Regarding it as a case of delayed union, Drs. Hulshizer, Condict 
and Riches were asked to see it with me. My diagnosis was confirmed, 
and a new plaster bandage ordered. This was applied on the day 

In a few days this dressing was split open, removed, and the leg 
thoroughly washed ; after which it was sprung on again and held in 
place by a few turns of the roller. From this time the splint was re- 
moved daily, the leg well cleansed and the cast re-applied. 

August 15 th, finding the tibia no stronger, I directed the patient to 
commence bearing weight on the limb, with a view of exciting irrita- 
tion and hastening recovery — the leg at the same time being well 
supported by a substantial plaster bandage. This plan of treatment 
was continued until the 16th of September, when it appeared as far 
from recovery as on the 8th of July, ten weeks previous. 

I then proposed cutting down at the point of fracture, and remove, 
if possible, any cause which might be acting against recovery. The 


patient became frightened and deeired to enter tlie hospital. He 
accordingly gained admission into Bellevne Hospital, New Tork, oa 
the 21st of Septemlwr. He was inuuediatel; subjected to the drilling 
operation, by which the tibia was bored at five distinct points in the 
vicinity of the fractnra. On the 7th of November he was dischaiged 
from the hospital. I then examined the leg and found it no stronger 
than on the 8th of July, four months previous. I waited one month 
longer to be certun the drilling process had fuled, and on the 7th of 
December decided to operate as I had proposed three months previous, 
by cutting down to the seat of trouble. With the asnstonce of Dra. 
Hnlshizer and Condict, I made a free longitudinal incision over the 
tibia. The opposing ends of the tibia were found united by a dense 
white Bubatance, which had the appearance of, and was, doubtless, 
flbro-cartilage. This, together with very small pieces of necrosed 
bone, was removed by a very narrow bone gonge. The incision waa 
closed by sutures and adhesive plaster, and the limb supported by two 
lateral splints of sole leather. The indsion healed kindly, and ceased 
to discharge after the third week. 

On the 7th of January the bone was Srmly united, and did not 
bend as before when the leg was lifted by the foot. 

On the let of February patient could bear his whole weight on this 
leg without the slightest deviation at the prant of fracture. 

At the time of this writing, April 1st, 1870, he walks quite well, 
over rough ground, unaided. There is no shortening; no deformity. 

If the opposing ends of a fractured bone are brought in appoution 
and retained there, it is rare indeed that we fail to get bony union, 
even if the fracture be compound. That failure is posuble, however, 
andoccauonally occurs in health; subjects and nnder the beat surgical 
management, has been proved repeatedly. Fiulure has followed the 
tzeatment by all of the popular methods, and in the hands of many of 
our beat surgeons. It has occurred in instances (paiticularly simple 
fractures) more difficult to account for than the one in question. Let 
us review the conditions necessary for the successful management of a 
broken bone, that no one may thoughtlessly use this case as an ail- 
ment agunst the use of plaster of Paris in the treatment of fractured 
leg. All treatment is divided into phyncal and eonstitvthnai manage- 

1st. To redaee tht fracture and maintain it in 

3d. To keep the titalfoTee* up to par. 


There are three causes for the motion and displacement of a broken 
bone — ^Voluntary and Involuntary Muscular Contraction, Gravitation, 
and Interference. An appliance which will m«st successfally overcome 
all these forces, with the least pain and discomfort to the patient, is 
the one to select. 

There is no doubt that muscular rest can best be secured by light 
equable pressure exerted over the muscles acted upon. In my opinion 
there is no appliance which so thoroughly accomplishes this, and at 
the same time so completely overcomes the other forces, as one or other 
of the so-called immovable dressings. Bandages saturated with liquid 
starch, or silicate of lime, or plaster of Paris, applied to the limb and 
allowed to harden, form a cast, and so constitute an immovable dress- 
ing. It may be split open, however, removed and re-applied without 
materially impairing its usefulness; hence they are often termed 
**' movable-immovable dressings." These dressings take the form of 
the limb to which they are applied, fitting it in all its contour. If 
properly made, as by one skilled in their use, they not only keep the 
bones immovably fixed in one position, but by increasiDg the area at 
every point which serves for counter-extension, lessen the liability to 
sloughing, and are more comfortable to the patient than any other 
form of appliance. 

In the past three years of private practice, I have treated with 
marked success (except the case in question) fractures at different 
points of the arm, forearm, thigh and leg. Some of these were com- 
pound ; three very severely lacerated. 

In lieu of these facts, who could ascribe this failure to the form of 
splint employed t — particularly since this method of treating fractured 
leg is endorsed by our leading surgeons, and employed so generally in 
the hospitals. 

The patient was in an excellent state of health ; tonics being used 
only during the first two or three weeks, when the discharge was very 
profuse. The discharge grew scanty and entirely ceased at a time 
when bony union ought to have taken place. There was no necrosis. 
There was neither a history of syphilis or osteomalacia, and I can 
assign no rational cause for the failure to at first get bony union, 
except the extreme injury done to the soft parts at the point of 

Of the plans of treating ununited fractures, perhaps not one has found 
more general favor with surgeons than the process of drilling the ends 


of the fiagmentf. It it tnie that boo j nnion hu followed connter- 
irritation, friction of the broken endi on each other, electricity, Ac. ; 
but snccesa bj the former has to oftea followed failure bj one or more 
of the latter methods, that it is now regarded as the operation most 
worthy of a trial. But there are conditiooB in which it also fails, and 
we are led to try a more formidable yst truly senaible method of cat- 
ting down to the seat o£ trouble, and removing the cause, if it may be 

In one instance the failure may be due to necrosis of the shaft ; in 
another to a detached fragment of bone or aome other foreign sub- 
stance between the opposing ends; in a third the broken ends maj 
haTe been kept separated, as, by undue extension, or, like the case in 
queslion, the bones may have been nicety reduced and kept in place, 
but for some reason, not easily accounted for, they have only united 
by a kind of fibrous tissue which cannot be formed into bono. 

DoTKR, May, 1876. 

Case of Empyema, 
bt hbhbt hulbhizbb, >f. d. 

On the 27th of February, 1875, was called to see Bamnel G , let 

19 ; found him snfiering with pleuro-pneumonia of the lefl lung, also 
pneumonia of the lower lobe of the right lung. Pursued the usual 
treatment in such cases, which was continued for ten days. Being no 
improvement. Dr. Condict was then called in consultation. Patient 
continued about the same for several days after this, when Dr. Rosd 
was also called in consultation. The treatment was then changed, but 
no improvement followed. 

March 16th. Percussion gives complete dullness over the whole of 
the left lung, encroaching on the right. Inspection shows marked 
fullness; heart's impulse just beneath the sternum but slightly higlier 
than normal. As the effu^on increased, the heart moved to the right 
border of the sternum. The area of dullness also extends beyond the 
median line. With these cbang 
the patient could no longer brei 
shoulders low. 

On the 21st of March, Drs. C( 
remove the fluid with an aspir 
thick to pass through the tube. 


was then introduced. On withdrawing the trocar there was a free 
discharge of healthy pus, to the amount of three pints. The canula 
was withdrawn, and the wound left to heal, which it did in three or 
or four days. After this time the patient appeared to improve for 
several days ; the heart, however, remaining well to the right. The 
contraction^of the left side was quite perceptible immediately after 

By April 3d the chest had again filled so as to make respiration 
more difficult. At this time Dr. Condict and myself again met to 
operate, but an examination convinced us that it would open inter- 
nally. The operation was postponed. Our apprehensious were well 
founded, for we had scarcely left the patient when he commenced 
coughing enormous quantities of matter. An opening was no doubt 
formed from the pleural cavity into one or more of the bronchial tubes, 
and through this the pus escaped. 

On the 6th of April it opened again externally, at the point of par- 
acentisis. The amount of pus discharged by the internal openiug 
must have been from two to three quarts, and less than this amount 
from the external opening at the last issue. The external opening 
continued to discharge four weeks, when it healed without trouble. 

From the 6th of April the patient gradually improved until the 6ith 
of June, when he returned to his home in the north of England. 

While he remained in this country the heart never returned to its 
normal position, but remained under the sternum. When last heard 
from, he was in good health, and at work in the mines in England. 

PoBT Oram, May, 1876. 

Case of Septicaemia, resultijsto from a 
comparative slight wound. 


December 24th, 1875, called to see Wm. B., a German, set. 28. A 
few hours before, while using a drawing-knife in the woods, the knife 
slipped and inflicted upon the knee-pan a wound about two and one- 
half inches long, and penetrating the patella. He had lost considera- 
ble blood, and I proceeded (not having my surgical needles with me, 
and being out of the town) to dress with strips of the "American 
- Skin Plao^ \ a roller bandage saturated with carboHzed 


oil (one part crystals to twenty of olive oil, with snfiScient glycerine 
to dissolve the acid), and directed perfect rest on the back. 

Dec. 25. Removed the plasters and soiled bandages, and re-applied 
the carbolised dressings alone. Found the wound not. uniting. 

Dec. 26. Had had some fever. Edges of wound gaping. Ordered 
small doses of aconite if fever returned, with nourishing food, and 
dressed as usual. 

Dec. 27. Knee not looking well. Had had what afterwards proved 
to have been rigors, alternating with flushes of heat, and followed by 
fever for an hour or two. The house being in a marshy ^*hole," sur- 
rounded by low hills, I concluded my patient was threatened with a 
return of his chills. I should have commenced at once with quinine, 
but delayed twenty-four hours, ordering only stimulants and nourish- 
ment, and adding to the fresh dressings a wide band of oiled silk. 

Dec. 28. Patient doing poorly ; wound gaping and of a purple red 
color ; knee swollen. His friends reported alarming " spells " and a 
sleepless night. Apprehensive of septic absorption, after dressing 
the wound and replacing the oiled silk, I ordered, twenty grains sul- 
phate of quinine after the next attack of fever, and four grains every 
four hours afterwards ; also generous quantities of old apple whiskey, 
and all the concentrated beef tea and milk that could be taken. The 
wound to be kept perfectly clean. 

Dec. 29. Patient had been at times delirious, and at times clammy. 
Found the knee much swollen ; not very red but very painful, espe- 
cially on the inner side; wound covered vrith a saniouspus (which was 
found in varying quantity for a week afterward). I punctured the 
most painful point deeply with an exploring needle, withdrawing only 
a little bloody serum. The puncture caused great distress at the 
time, but was a useful procedure. The abscess I was looking for did 
not occur. Continued the quinine in full doses; discontinued the 
carbolized oil, and dressed the wound as follows : powdered the wound 
thoroughly with pure salicylic acid, then wrapped the knee in a hot 
poultice medicated with Labaraque^s solution, then wrapped the 
whole with double thickness of dry flannel, then swathed it with 
oiled silk. This process to be attended to twice or thrice daily. 

Dec. 80. Had had sinking turns, with clammy sweats, followed by 
fever and delirium, but found him rational and the climax apparently 

From December 80th to January 8d I attended him twice daily, 


while his system struggled with the septicsBmia, and witnessed alter- 
nate improyements and periods of sinking and threatened collapse. 
The wound was dusted morning and evening with the powdered 
salicylic acid; the hot poultices, medicated with the muslin wrung 
from Labaraque's solution, were faithfully continued, and the knee 
was kept swathed in flannel and oiled silk. Internally, I added to 
the quinine, ^^ Beef Wine and Iron'' for the appetite, as well as the 
most generous diet. 

The periods of sinking fortunately grew less in frequency and dura- 
tion, while the knee and leg gradually became smaller, and the wound 
assumed a more satisfactory appearance, filling up with healthy gran* 
ulations, and finally closing from the edges. A week later, the patient 
walked two miles with comparative little fatigue and only temporary 
swelling, and is now doing well. 

The case is interesting as showing the danger, especially with 
unfavorable hygienic surroundings, of apparently slight bone wounds; 
the indispensable character of quinine, should there be purulent infec- 
tion, and the great value in the treatment of wounds of salicylic acid, 
topically combined with perfect exclusion of air, and the production 
of local diaphoresis by means of the poultice and oiled silk method. 
I may add, in concluding these hurried notes, that the temperature of 
my patient, taken in the axilla, did not fall below 98 degrees nor 
exceed 102 degrees Fahrenheit. 

MoBBiSTowN, May, 1876. 


»Y J. Q. RYBRSON, M. D. 

I. — Fracture of the Epiphisis. 

On June 7, 1875, was called to see J B , a boy aged 15 

years. On the day before, he fell eight feet on his left shoulder. I 
found a rather large rounded prominence in front of the coracoid pro- 
cess, below the clavicle. His friends said the swelliug was there im- 
mediately after the fall. 

The belief that a dislocation had occurred suggested itself so forci- 
bly that at once I attempted to reduce it. Being unsuccessful, and 


finding I gave considerable pain, I tried again with the use of cblero- 
form. While manipulating I got a muffled crepitus : it then occcurred 
to me, what I ought to have known at the first, that the case was one 
of fracture of the epiphisis. I had read Dr. E. B. Moore^s able paper 
on this subject, delivered before the American Medical Association of 
the year before, and it was plain that this was a well-marked case of 
that kind of fracture. The head of the bone could be felt in the gle- 
noid cayity, there was slight shortening, crepitus, and a rather large 
rounded^prominence in front of the coracoid process. 

On account of the tenderness produced by the handliug, the dress- 
ing was deferred until the seventh day. It was then dressed somewhat 
after Clark^s method of treatment for the fracture of the surgical neck. 

The fracture was reduced by carrying the arm forward and upward. 
The upper end of the lower fragment was kept outward by a pad in 
the axilla, and somewhat backward by a strip of adhesive plaster 
around the humerus and around the body. Another plaster com- 
mencing from the outside of the arm above the middle, to below the 
elbow, and up to a point opposite on the inside of the arm. A weight 
was suspended from the loop below the elbow to produce extension. 
The arm was then bandaged, the forearm flexed to less than a right 
angle, with the elbow near the side and a little to the front. 

The dressing was entirely comfortable, and when removed on the 
twenty-fourth day after the iojury, there was little deformity, and 
every motion of the arm was perfect and complete. 

Although the result was very satisfactory, still if at the time I had 
been familiar with Swineburne's apparatus, as recommended by Dr. 
Moore, I should have used it, as I believe I shall do in my next case. 

These cases are of interest because most practitioners make the mis- 
take of supposing they have a dislocation, whereas a dislocation 
almost never occurs. If the fracture is not recognized, permanent im- 
pairment and deformity will result ; but, if properly treated, there is 
no fracture in which the union is more rapid and perfect. 

I took occasion in this case to verify as far as possible the points of 
pathology and diagnosis spoken of by Dr. Moore. I believe he has 
elucidated the subject most thoroughly. 

BooNTON, May, 1876. 


II. — (Edema of t?ve Glottis. 

On the 16th day of April, 1875, D M , a healthy man, forty 

years of age, gardener by occupation, consulted me about his throat. 
He said it had troubled him for two or three days, and he had sup- 
posed that he was " going to have another attack of quinsey." I 
could find only a little redness and swelling about the fauces. 

On the 17th, he said his throat was worse— that it pained him. The 
appearance was much the same as the day before, except that it ap- 
peared more livid. I told him there was not much trouble, but he 
thought there was. Was called in the same evening, when he told 
me that he feared there was more trouble than I supposed. His 
voice was not affected, no difficulty in breathing, countenance some- 
what pale, pulse a little more frequent and rather email. There was 
pain about the larynx, with livid appearance of the fauces. I left him 
without being able to quiet his apprehension. 

At about daylight the next morning I was aroused by his wife, who 
said her husband " had a smothering in his throat.'* The patient 
lived only a few rods off, and I went there as quickly as possible. I 
found him on the verge of suffocation. I was told that a few minutes 
before he had attempted to gargle his throat, and immediately he had 
great difficulty in breathing. 

His pulse was 125, small and weak, countenance pallid, eyes sunken, 
and lips livid. The breathing, both in expiration and inspiration, was 
loud and extremely difficult. He pointed to the larynx as the cause 
of the trouble. This examination convinced that it was oedema of 
the glottis. 

I proposed to operate at once by the mouth, and in case of failure 
to open the trachea. At this time Dr. S. Pierson. came and confirmed 
the diagnosis. At his suggestion, instead of using a hernia-knife, an 
ordinary hatchet-shaped gum-lancet was used, the handle and blade 
together measuring five inches. While Dr. P. held the head firmly 
back the left index finger was crowded firmly down until it reached 
the rim of the glottis ; the point of the lancet was then carried beside 
the finger until it reached the rim of the glottis ; after two or three 
strokes of the lancet both the finger and the lancet were withdrawn. 
The patient immediately drew a full inspiration, and said, " I am 
well." And he was well, for the relief was immediate^ complete and 


After the withdrawal o: 
Btreaked with a alightlj ra 
time when first smnmoued n 
the patient was relieved. 

(Edema of the glottis is a 
before they are seen bj the 
read; to operate. 

The hernia-knife and a co 
seldom at hand, while the g 
titioner. It is safe, and if 
introduced wholly withiQ tb 

It is qnite generall j recom 
opened at once. Accordin) 
been reported that were reli< 
relief by the month ought h 
be qnickly and safely trie< 
operating by the month, it n 
a medical man can do that g 
is carried at once from impel 

BooKTOH, May, 1876. 




I am persnaded, both from 
authorities, that chronic dyse 
lence, and often a very una 
result that has attended a ps 
this kind, I am led to report 

Mra. Annie L., aged 68, hi 
with dysenteric symptoms, fo 
care for treatment The sert 
had greatly reduced her. 1 
and offensive ; at other time 
only two or three discharges 
constant going to stool. Son 


natural in appearance ; then they woald become bloody, or slimy, or 
parulent, with perhaps scybala. The evacuations were generally pre- 
ceded by a sharp pain in the rectum, and were followed by a torment- 
ing unsatisfied condition of the bowels, which the patient termed a 
" loose feeling." 

I prescribed an occasional aperient, followed by opiates and astrin- 
gents, antacids, tonics, &c., w^th yarying effect. Sometimes she ap- 
peared better, at others worse. Her general health did not improve. 
I varied the treatment from timo to time as I found that one or other 
of the prescribed remedies failed to produce the desired effect. Her 
diet was restricted to the most nutritious and easily digested food. 
Opium had such a disagreeable effect that I was forced to discontinue 
it. I then gave her teaspoonful doses, ter-die, of the sub-nitrate 
of bismuth for several weeks. There was some improvement, but no 
cure. At the suggestion of my friend Dr. Mattison; I gave her a 
course of silicine, until she had taken two or three ounces, but with 
only temporary relief. Other physicians were counselled, and some of 
their ** never known to fair' prescriptions faithfully but unsuccess- 
fully tried. She became more and more emaciaiifed, until she was 
truly nothing but ^^ skin and bones," and her demise was considered 
close at hand. When about to give up in despair, I fortunately ob- 
served in the " Compendium of Medical Science," a report of obstinate 
cases being successfully treated by irj actions of chlorate of potassa, 
peranum. I immediately directed an injection of two ounces of a 
saturated solution (water and glycerine in equal parts,) after each pas- 
sage, or at least two or three times a day. The glycerine was soon 
omitted from the prescription and a simple watery solution*6ubstituted. 
At first the patient could not retain the injection ; this was partly, 
overcome by keeping her in the recumbent position after each injec- 
tion. The fluid was generally retained about half an hour. 

I visited her in two or three days after instituting the above treatment 
when in exchange for the usual reply *' no better," she said she " guessed 
she was doing middling well," and convinced me of the truth of the 
assertion by directing me to a vessel containing recent dejections. I 
will never forget their appearancei, for, aside from fecal matter, slime, 
&c., there was at least a handful of scabs and what ai)peared to be 
shreds of membrane. There was one strip which measured half an 
inch in width and three and a half inches in length. The discharge 
maintained this character, except that in a few days the scabs ceased 



to kppesr. Althongb greatlj reliered, coDTalescence vn not u rapid 
M I bail hoped fur. She iiiil complained tome of ibst looee fe«liiig, aa 
■he deacribed it. Althoagh the pauftges were geoerall j quite aataral, 
bolh ia sppeiTuice and freqaencj, yet tbey would occuioDally aasDme 
the old character. Suspecting ulcerations higher up, I now substituted 
the Taginal for the rectal nozzia, whea more scaln appeared, and the 
patient took another itep forward ; but, as before, the; soon ceased to 
come, and although there was a decided improvement, she fonnd 
another baiting place. I then attached a large sized gum catheter to 
the sjringe and bad her introduce it the whole length. It was an old 
one and allowed the fluid injected to ooze from alludes like a strainer. 
This waa followed b; another harveat of scabs; but the; soon ceased 
to come and mj patient slowly, but surely, improved. She still bad a 
relaxed condition of the bowela, however, which waa eaaily controlled 
by 5 to 10 gra. doses ter die of a powder composed of equal parts; 
Dover powder, sab-nitrate of bismuth, tannin, and sulphite of soda, 
whioh I had before administered with quite good effect, only that it 
was powerless to perform a cure previous to the nse of the iDJecliona. 
She also wore (suspended from the shoulders) upon tbe bowels a large 
thick compreis, frequently wrung out of cold water, which abe thooght 
did ber an immense amount of good ia removing tenderness and gor- 
ing tone to the bowels. She is now well, and has passed through two 
diarrbtB^l seasons without a return of bowel complaint, I am 
prompted to report this case from a desire to help bring to the 
attention of the profesuou a means of treatment which I bave great 
reason to believe is not much resorted to, in this tedious, intractable 
and often fatal disorder. 
UiDDLB Vallei^ May, 1876. 

To Chairman of S'""-^-'"" '^™™--«— 

In accordance wi 
as to the valne of 
throat, and also a: 
considered the mo 
notes to the diffen 


trict Medical Society, to which but one, Dr. A. W. 
Rogers, has responded. He says : ''In answer to the 
query in regard to the topical applications in malig- 
nant sore throat, I would say that I seldom make any 
except by the way of a gargle, and swallowing the 
medicine. In diphtheria I usually trust to the appli- 
cation made in swallowing the quinine and iron, 
chlorate of potash and alcoholic stimulants, which 
alike serve for the constitutional and local disease. I 
have tried the carbolic acid spray, but without much 
satisfaction. I have not tried salicylic acid. When 
the patient can gargle the throat, I have seen alum, 
tannin and glycerine of benefit, and have occasionally 
applied to the tonsils the alum and tannin in powder. 
I also think well of a gargle made of yeast, honey and 
brandy. Some very bad cases of diphtheria I have 
seen recover without any local application, under full 
doses of quinine, tr. chloride of iron and brandy, and 
have known many to perish where the most diligent 
use of escharotics was made. 

The cases in which I now think calomel of the 
highest value are the second stage of croup and some 
cases of pneumonia. I would hardly undertake to 
treat any decided case of croup, if I were debarred 
from tliQ use of this potent remedy. If emetics and 
the adjuvant treatment do not give decided relief in 
three or four hours, I immediately begin to give a 
grain of calomel and a quarter to half a grain of 
ipecacuanha every hour ; and if there be much of the 
stridulous breathing, sometimes every half hour, and 
continue it until the harshness of the cough and the 
tightness of the breathing are relieved. I know noth- 
ing like it to alter the plasticity of the exudation, 
which in this disease packs the larynx and trachea, 


and thus shuts out the vital air. At the same time I 
give much more attention to securing nutriment and 
avoiding catharsis, excessive perspiration, and all the 
prostrating remedies, than I did in the early part of 
my practice, when all these things were counted so 
important as antiphlogistics. Tartar emetic, except- 
ing one or two emetic doses in the very early stage of 
the disease, and very minute doses afterward in the 
more robust, I think a dangerous remedy from its 
very rapid prostrating effect. In mild cases, ipecac is 
much to be preferred, and in the severe cases there is 
nothing like the turpeth mineral (sub-sulph. mercury) 
for promptness and efficiency as an emetic, without 
much prostration. 

Where the secretions are scanty in pneumonia, and 
the expectoration a rasty or blood-colored frothy 
mucus, the dyspnoea great, and the substance of the 
lung becoming rapidly hepatized, I know ofvnothing 
so reliable to arrest this condition of things and to in- 
sure an early resolution of the disease, as small and 
frequent doses of calomel combined with opium and 
ipecac. It is not necessary to carry calomel to the 
extent of risking salivation, if the case be cautiously 
watched, and it forms but a part of the necessary 
treatment ; but in my judgment it often forms a very 
essential part, and the most diligent use of all the 
more modern remedies in many cases will not supply 
its place. I have seen speedy relief from its use too 
often to doubt its efficacy, and would feel guilty did I 
not occasionally resort to it." 

During the past year, Paterson has been visited by 
scarlatina and diphtheria, and also by a few cases of 
variola ; the latter, however, was pretty thoroughly 
isolated and quickly controlled. 


Of diphtheria there have been many cases, with 
quite a large percentage of deaths. The treatment 
which in the hands of your reporter has been most 
successful, is that which is directed to the disease as a 
constitutional one entirely, and, as such, to be treated 
by general^ rather than local remedies. Of these, 
the tinctiire of the chloride of iron and potassium 
chlorate, with stimulants and alimentation almost ad 
libitum^ have appeared to yield the best results. 

Sc<arlatina has presented about its usual variety of 
type ; in some instances being so malignant as to over- 
power by its poison in a short time ; in others so mild 
as scarcely to call for medicine at all. 

In March and April, 1876, the epidemic of influenza 
which spread so extensively through the Middle 
States, prevailed to quite an extent here, but was 
generally more annoying than dangerous. 

Our District Society is in a flourishing condition, 
numbering over thirty members. 

Since the sending of the last report, our President, 
Dr. Orson Barnes, has been removed by death. After 
a lingering illness, he died July 23d, 1875, in his 46th 
year, sincerely lalnented by a large circle of friends 
and patients, and respected by his associates in the 

Appended are cases of interest communicated by 
Dr. A. W. Rogers. 


Patbbsok, May 8th, 1876. 

2d4 icxDicAL socrsnrr of utew tebset. 


BT A. W. BOOKB8, K. D. 

I. — Report of Case of Scarlet Fener. 

About noon, December 6tb, 1875, 1 was called to see Era H., aged 
about fire yean, who had been taken sick the day before. I found 
her semi-conscioas ; skin dry and hot, with a slight general eruption 
on it, and here and there patches of a deeper hue. Her tongue was 
red at the end, coat%l at the back part, her lips dry. She had a con- 
Tulsine working of the mouth ajkd bead, and a knitting of the brows. 
She would not respond to any request Her pupils responded to 

I ordered her to be put in a tepid bath every two hours, and to 
keep a moist bandage around her body between the baths ; also to 
anoint her with oliye oil and lard every eight hours. Oaye her brom- 
ide potassium, five grains every hour until she was more comfortable, 
and a tea^spoonful of a moderately strong solution of chlorate of 
potash every hour. 

7 P. M. In all respects about the same; baths and medicines 
administered as ordered. 

Dec. 7, lOi A. M. Tongue red and clean as far as can be seen ; not 
quite so mnch convulsive twitching of the face ; at timea she looks a 
little more intelligent ; pupils respond to light. She seems sick at 
the stomach occasionally ; neck a little swollen. I could not get a good 
look at her throat; there is some snuffling at the nose; temperature 
102}^. Baths «nd medicines continued the same ; ordered a milk 
punch to be given her occasionally. 

P. M. Child has rested more; has had the baths and medicines 
well administered. Her mother says that she is always more com- 
posed af^er the bath. She seems less nervous, and has been at times 
more intelligent 

Dec. 8^ 10 A. M. Child more quiet, but does not respond to ques- 
tion^ ; pupils sometimes contract and dilate widely in the same light 
Pulse over 100, very feeble, irregular and indistinct; temperature 105. 
Has had baths, cold to the head, and iced drinks. The eruption is 
not uniform ; irregular patches of more or less intense redness are 
scattered here and there over the body ; continued the same treatment 
P. M. T<xnperature 104^; pulse very weak; parents say that she 
knows them well at times, and then relapses into an unconscious con- 


dition ; continued the moist cloths to the body, and the bath occasion- 

Dec. 9, 0)- A. M. Child appears more intelligent — notices her 
playthings ; temperature 103} ; pnlse small and frequent She 
swallows pretty well, and has taken some nutriment and milk punch. 

5 P. M. Temperature 103 ; is more delirous ; hard to get her to 
take anything. 

Dec. 10. In all respects improved ; she takes nourishment better ; 
the temperature is less and the pulse stronger. The baths were con- 
tinued, but not so frequently. 

On the 11th, moist cloths were substituted for the baths. I contin- 
ued to give her some bromide potassium, and gave also some expect- 
orant mixture of squills and seneka and spts. nitre, as she had some 
cough. I also directed her to have on the 10 th and 11th some 
injections of brandy and milk, as she did not appear to take sufficient 
nourishment. She was yery restless, but her temperature was less, and 
she was more intelligent. From this time she rapidly improved, and 
made a good convalescence. The chief points of interest in this case 
are the severity and evidently congestive form of the disease, the 
apparent and decidedly beneficial effect of bromide potassium in 
allaying the nervous symptoms, the lessening of the body heat by the 
frequent use of tepid baths (which were but tepid, and during the 
hot stage of the disease almost cool), and the benefit of stimulus given 
by the stomach and by injection, in sustaining the action of the heart. 

I have been in the habit, during all the course of my practice, of 
using tepid and cool baths during the hot stage of scarlet fever, 
having learned the treatment from Dr. Curriers reports, and the cor- 
roboration of its success by Dr. Gregory, of Edinburgh, as published 
in his Practice of Medicine, which was the common text-book when I 
was a student ; and of late years I have been more and more convinced 
of the importance of its being the principal part of the treatment of 
this disease. 

When the child is lifled from the bath, without drying, I have it 
wrapped in a warm flannel or sheet and laid in the bed ; this prevents 
fatigue and annoyance, and allows it immediately to rest, and thus 
more benefit is obtained by the procedure. I sometimes have it put 
in the bath every hour, or every three, four or five hours, according to 
the degree of heat and restlessness. 

Patebson, May, 187G. 


II. — Excessive deposit of Fat over the Abdomen. 

In December, 1874, I saw Mrs. J. D., aged about 60. She was sit- 
ting up and panting, with a good deal of d^spncea. Her abdomen 
appeared enormously distended, and there was also great swelling of 
both legs ; on one the skin was broken, and there was much weeping 
from it. Her countenance was florid, and *the veins of the head and 
neck were full. Her pulse was regular, and of moderate fullness and 
frequency. Her urine was scanty, reddish and turbid, and yielded a 
littl^ albumen on testing. She said that she felt great oppression in 
breathing, and that this condition had been coming on for some 

I prescribed for her acetate of potash and infusion of digitalis, 
which was continued three or four days, without effect. After that I 
ordered full doses of- bi tartrate of potash. This loosened the bowels 
and acted a little upon the kidneys — but very little. I also tried 
some other diuretics, without benefit. She was very uncomfortable at 
night, and could get no rest. About the tenth night from the time I 
first saw her, I sent her i gr. of sulphate of morphine. She slept 
some during the night, but in the morning the breathing was more 
oppressed than ever, and the return of blood from the head and 
extremities more obstructed. Her pulse became very feeble and 
irregular; the abdomen appeared much distended, and yielded no 
resonance or percussion over the middle or lower part of it. Hoping 
to relieve her by tapping, I pushed in a trocar 2} inches long, about 
two inches from the linea alba, and three inches below the umbilicus. 
It seemed to enter a cavity, but no water flowed. I then tried it in 
another place, with the same result. Leaving the canula in position, I 
passed through it a smaller trocar 4 inches long ; no water, but a few 
drops of blood, flowed out. Her breathing was becoming more and 
more obstructed, and she died in an hour. After death I passed in a 
long and large aspirating needle at the point of the first puncture, 
and drew off a basin full of turbid serum. I then opened the perito- 
neum, and found no more water of any consequence ; but the fat on 
the abdominal wall measured five inches deep. The wall itself was 
thin. No farther examination of the body was permitted. 

Paterson, May, 1876. 


III. — Report of a Case of Chorea. 

On the morning of Monday, January 23cl, 1876, 1 was called to see 
A young woman in her eighteenth year, of fair complexion and light 
hair, the oldest child of parents, both of whom were of a nervous 

She had decided chorea contortions ; the mind was also affected, 
and she had the usual willfulness and yacillation appertaining to this 
disease. The contortions were unusually constant and seyerc. She 
had been out at Ichurch the day before, and seemed pretty well, but it 
was afterward remembered that there had been something peculiar in 
her manner for some time before the attack, which now appeared to 
come on suddenly. Though not at all deficient in intellectual 
capacity, she had been unusually childlike in her manner and tastes. 
She had never menstruated. 

I prescribed for her, at this visit, emenagogue pills (Hooper^s), one 
pill twice a day, and Fowler's Arsenical Solution, four drops three 
times a day. I did not see her on Tuesday. On Wednesday morning 
between 8 and 4 o'clock I was called to see her, because of the violence 
of the contortions and her inability to sleep. I gave her some bromide 
of potassium, which quieted her somewhat. In the forenoon found 
her no better ; increased the dose of Fowler's solution to six drops, 
and gave her some brom. potassium during the day ; also ordered her 
to have a shower-bath. During Wednesday evening and night she 
was very bad ; the contortions were very violent. I gave her at night 
two scruples of bromide of ammonium and 1-6 grain of sulphate of 
morphine. She slept but little, but writhed about, jerked her arms, 
head, legs and body continuously, and made most violent contortions 
in attempting to speak or swallow. She puffed, smacked, snorted 
and gulped, rendering it very difficult to get drink or a dose of 
medicine administered. 

On Thursday she was a little more controllable, and had a bath. 
She took some breakfast of bread and milk. During the day I gave 
her some bromide of potass, and ammon. In the evening the spasms 
were again severe. I gave her then a dose of morphine to procure 
sleep, and administered chloroform, but with very temporary effect. 
She slept a little, but not long. 

Friday morning she was about the same, but rather weaker. De- 
spairing of doing anything with the arsenic in so violent and acute a 


caae, I chasged it to sulphate of strychnia, beginning with 1-40 gr., 
three times a day, and intending to increase it according to its effect. 
Friday evening, tried to procure sleep with chloral hydrate, admin- 
istering 25 grains in some sweetened milk. She was much disgusted 
with the taste, and, as it did not gire her sleep, late at night I gave 
her a hypodermic injection of i grain of sulphate of morphine, after 
which she slept some hours. 

Saturday morning she was evidently weaker ; the spasms and con- 
tortions were about the same ; it required constantly two persons to 
keep her in bed ; her limbs could only be kept quiet by rolling them 
in the bed clothes. She found more difficulty in expressing herself, 
and in taking food ; when she did speak, her mind was clear. At 
times she perspired a good deal. Her pulse was very difficult to 
count, owing to the contortion of the arms, but was evidently very 
rapid and feeble. 

In the evening there was no improvement— she was rather worse. 
I put her under chloroform for an hour, which gave her rest for a 
while, after using it; in the night it was again administered, and she 
slept quietly for three hours. During the day (on Saturday) I direct- 
ed epts. turpentine to be applied to the spine. 

Sunday morning she seemed very weak, and the pulse indicated the 
need of stimulants ; gave her some milk punch very early on Sunday. 

At 9 o^clock there was less spasmodic action, so that she could 
swallow better, and she took some more nutriment; but at 10 o^clock 
she commenced to vomit, and vomited several times during the day. 
Ice was applied to the upper part of the spine, as was done also on 
Friday and Saturday, and appeared to relieve her somewhat. 

During the forenoon, she was evidently growing weaker ; respiration 
was more hurried and shallow ; pulse rapid and feeble. 

At 11 A. M., Dr. R A. Terhune, of Passaic, saw her with me. 
Although the case appeared to him very grave, he still thought that 
she might recover. He could not see that it was anything but a much 
aggravated , case of chorea. At this time, although so feeble, she 
could put out her tongue when requested, and answered correctly 
though with difficulty. She continued to vomit, notwithstanding 
the usual remedies for this symptom, through the afternoon and night. 

At 4 A. M., on Monday, she was extremely restless, breathing very 
shallow and hurried ; from being hot the extremities became cold ; 
her whole body appeared in a quiver, and she died at 5 A. M. 


I have seen many cases of chorea yield to arsenic, and some to large 
doses of sulphate of zinc and other remedies, and have usually com- 
menced the treatment with confidence, and, antil I encountered the 
case now related, had no proper conception of what might be its 
awful seyerity and rapid progress to the death of its subject. The 
<< insanity of the muscles,'* like that of the brain, sometimes seizes its 
ylctim with such a savage, unremitting and unrelenting grasp, that 
not only the proper function but life itself soon yields to the foe. 

Patbbson, May, 1876. 

IV. — Apoplexy following PneuTnonia. 

I was called April 5th, 1876, to see Mr. H. W., a farmer, aged 52 
years, of rather spare frame, temperate and active habits, who had 
usually enjoyed good health, but was given to smpkiog a good deal. 
I found that he had kept the house for a day or two and had suffered 
general symptoms of influenza, which was at that time prevalent in 
this vicinity. After a day or two, his cough increased and he had 
rather severe pleuritic pain ; he was relieved of this by a blister, and 
appeared much better, when some decided symptoms of pneumonia 
became manifest. This reached its worst about April 12th or 13th, at 
which time, to relieve the cough at night and to give him some rest, a 
dose of sulphate of morphine (l-6th gr.) was Administered for several 
successive nights ; about this same time, during the exacerbation of 
the fever in the evening, he had some delirium. On the 16th, visiting 
him in the morning, I found he had very little cough and no difficulty 
of respiration ; his pulse was moderate, the lungs clearing up nicely, 
physical signs good, and all his symptoms improved ; but he had gone 
into a taciturn and rather sullen mood and refused to take any more 
food or medicine. He had been taking some quinine every forenoon, 
and some diuretic and expectorant mixture in the afternoon ; also a 
moderate portion of milk punch, beef tea, &c. His condition not 
being urgent, I did not press upon him medicine or food; except the 
latter, in moderate degree. After a day or two, this mood passed 
away, and he was as cheerful and reasonable as could be desired ; he 
appeared every day to be gaining strength, and was sitting up part of 
the time, when late in the afternoon of April 23d, he was taken with a 
chill ; to this succeeded a comatose condition, and some arterial ex- 
citement, attended with some slight convulsive movements of the head 


ai^d limbs; the coma became more profound until he died on the after- 
noon of the 24th. (Dariaji; life no abnormal heart sounds could be 
detected.) /What the proximate cause of this sudden attack which 
ended in death beginoiog at the brain was, whether hermorrhage, 
embolism or thromboses, circumstances did not permit us to discover, 
but the esse shows how suddenly the physician^s hopes may be dis- 
appointed when recoyery is certainly expected. 
Patbbson, May, 1876. 


To Chairman of Standing Committee, cfec. ; 

From Yemon, Dr. C. Allen writes: ''The health, 
within the limits of my practice for all the fore part of 
the past year may be reported generally good. The 
cases calling for medical attendance were generally 
unimportant ; the exceptions were cases of peritonitis, 
rheumatism and gastralgia. The first two yielded 
readily to the usual modes of treatment." Speaking 
of peritonitis he says: "Authors pronounce it an 
idiopathic affection— one of the rarest of diseases — and 
find its most frequent cause to be perforation of the 
alimentary canal from ulceration, &c. I cannot say 
my experience coincides with this view. It appears 
to me to be nearly as common as pleuritis or inflam- 
mation of other serous membranes, and from similar 


He also reports a severe and protracted case of gas- 
tralgia, ending in recovery. Epidemics of scarlatina, 
measles and hooping-cough, have prevailed in his 
vicinity during the winter and spring, though not of a 
severe type ; ' ' but the pneumonia and bronchial in- 
flammations have beenmore prevalent and severe than 
usual ; all, however, ending in recovery save one case, 
which has gone on to suppuration ; two abscesses have 


discharged, and now, unfortunately, a third seems 
ready to follow." 

Dr. Moore, of Deckertown, informs me that there 
was an epidemic of diphtheria in that vicinity last 
autumn, and during the winter and spring an epidemic 
of influenza and pertussis. He uses belladonna in the 
latter disease with gratifying success. In this practice 
there have been several cases of scarlet fever of the 
anginose varietj'', ending in recovery with one excep- 
tion. The poison was directly traced to the clothing 
of a child who had died in Connecticut and which had 
been brought here. Of true diphtheria there were 
three cases in one family, two of which proved fatal. 
The remedies used were chlorate of "potassa, mur. 
tinct. ferri., quinia and alcoholic stimulants, while the 
vapor of lime-water was kept constantly in the apart- 
ment. No other cases occurred. During the year 
there have been many cases of herpetic sore throat, 
which yield readily to a cathartic and chlorate of po- 
tassa. Some practitioners, who we believe know bet- 
ter, persist in calling these cases diphtheria, notwith- 
standing they do not possess one of the essential 
elements of that most fatal and malignant disease. 
Pneumonia and bronchitis have prevailed during the 
winter and spring ; and if one may judge from outside 
reports, the former has been more than usually fatal, 
though not with us. The epidemic of measles and 
hooping cough mentioned by Drs. Allen and Moore, 
extended to this community. In many instances 
there were pneumonic and bronchial complications. 
Almost eveiy man, woman and child in this vicinity, 
was complaining at one time this spring of the *'cold 
that's going round ;" epidemic bronchitis or influenza, 
the symptoms of which were frontal headache, coryza, 


fever, loss of appetite, &c. Most of the cases were 
treated by domestic remedies, but occasionally the 
severer ones called for free purgation, followed by 
Dover's powder. 

Malarial poison shows itself during the spring, sum- 
mer and fall months, in the form of chills and fever, 
neuralgia and cephalalgia, for the speedy relief of 
which no remedy is quite so effectual as quinia. 
Isolated cases of typhoid fever have occurred during 
the year past, one case only proving fatal. 

Since the last meeting of the Society, one of our 
active and useful members. Dr. E. W. Mains, of 
Flatbrookville, has been removed by death, in the 
prime of life ; having the confidence of the com- 
munity, his untimely demise is a severe loss to his 
friends and to the profes'sion. 

I enclose a communication from Dr. Thos. Ryerson, 
and a case by Dr. Carlos Allen. 

J. P. COUSE, Rep<yrter. 
Hambubo, May 18th, 1876. 

Communication by Dr. T. Ryerson. 

Ist Let me caU the attention of such as are not already famiUar 
with it, to the yalae of iodoform, the analogue of chloroform as a 
local ansesthetic in painful ulcerations, especially at the rectum, ulcer- 
ating cancers, and in bums and scalds. My attention was directed to 
it by Dr. Van Buren, of New York. I use glycerole amyli as the 
excipient— an ounce of it with twenty grains of the iodoform — and 
apply with a camel's hair penciL I doubt not that it may admit of 
extensive application. 

2d. I wish to report, that full ansesthesia, by a mixture of chloro- 
form and ether, has, in at least one case, produced entire relaxation of 
the uterus, during labor. That case was a primipara, whom I visited 
m consultation with Dr. A. The head presented, and was almost im- 
pacted, because in the position of extended chin or occipito-frontal 


diameter transyerae, engaging at superior strait. As the woman had 
had a violent and prolonged. attack of abdominal pain, simulating 
peritonitis, it was thought that version would be hazardous. This is 
ordinarily the first mode of management, at least in multipara. In 
primipara it is hazardous to the child, because the head must be de- 
tained at the outlet by a tense perineum. But in these cases ordina- 
rily the forceps are apt to increase the extension of the head, and I 
have no faith in the vectis. I have seen the use of the forceps neces- 
sarily followed by the use of the perforator and crochet On the other 
hand, by version I have terminated several cases well and speedily. In 
this instance I decided on trying the forceps, on account of fear of 
peritonitis following version. The patient insisted on ether, which is 
barely tolerable in operative midwifery. The forceps were introduced 
readily; but not locking readily, were strongly depressed, without 
proper attention to the fact that this operation always tends to push 
them into the uterus. Refusing to lock, they were withdrawn for re- 
introduction. Proceeding to this, what was my surprise to find the 
head entirely receded, precisely as if the uterus was ruptured. I at 
once did a version, and, on account of the delay of the head, finished 
with the forceps. Bat the child was dead. Suffice it to say, there 
was no rupture. I had feared that it had resulted from a supposed 
powerful contraction during the fall anaesthesia of the first introduc- 
tion of the forceps. The ether was withdrawn as soon as the version 
was begun, so as to secure full contraction — very important indeed if 
there had been rupture. The simple explanation is, that the ether 
relaxed the uterus, and the act of depressing the forceps handles 
brought the blades against the foetal body and pushed it back. Every 
one can read the lessons which this case teaches. 

8d. Although stone in the bladder is rare, yet it does occur in 
New Jersey. I wish to say that any physician who is familiar with 
the use of the solid bougie, may treat every case proper for lithotfity 
if he will carefally follow Sir Henry Thompson's admirable treatise. 
Indeed, it may be said in passing, that his several works on diseases of 
the urinary organs are destined to be classic for a long time. My 
authority for this assertion is, that I crushed an oval stone (principally 
urates) ( by ^ inch, with one of Thompson's lithotrites, the first instru- 
ment of the kind I had ever handled, in three operations. The 
patient has been now two years free from all symptoms of stone. One 
of the fragments was seized with the alligator forceps in the beginning 


of the membruious urethra, bat wm 
alter a fuller dilatation of the passage. 
pted eight minutes, and was slightly re 
&z. The third, however, followed in e 
conaumed fire mioates. 

Case bt Dr. Cae 

I haTC not often in my professional 
for sperm atorrh cm, the sequel of vicioi 
man of 33 applied to ms to perfcrm th 
him, haviog sufftired for years from this 
thing he could find on the subject, and 
read of in vain. I do not mention the 
lars. I treated him with bromide cf 
grains three times a day, and increasin 
dose. The effect has beeo quite sati 
checked in frequency to once in two ' 
perceptible change in the feelings and b 

Most clearly the medicine has sbnn 
sensibility of the parts involved in this 

Vkknon, May. 1870. 


7h Chairman of Standing Ci 

The sanitary condition of fl 
last passed, will compare favc 
previous year. With a poptila 
thonsand, I can say of this ( 
think can be said of no other 
popnlation, viz : that there -wf 
city limits from Aitgust 8th to 
residence of more tlian ten yea 
summer to pass with so little in 


SO little sickness of any kind. In the fall there was an 
epidemic of diphtheria ; but in proportion to the num- 
ber of cases, there were as few deaths as could reasona- 
bly be expected. 

December 5th, I saw a boy aged 9 years ; he com- 
plained of ''pain all over," and said his "throat was 
a little sore, but not much." Upon examination, I 
found on one side a slight diphtheritic exudation. I 
gave him tr. iron, quinia internally, a gargle of alum, 
chlorate potass., fl. ext. sumac, glycerine and rose- 
water, and ordered a generous diet. The next day I 
was unable to see him, but on the 7th I visited him 
early. Upon examination, the .whole throat seemed 
one mass of diphtheritic deposit ; apparently nothing 
passed into the stomach, for on attempting to swallow 
milk, it poured from both nostrils ; however, as this 
process lessened the amount, some of the milk must 
have entered the stomach. He continued much in this 
condition till the 14th, when the amount of membrane 
appeared somewhat lessened, and gradually disap- 
peared, so that by the 19 th, his throat was clear. 
During the whole time he had the same diflBculty in 
swallowing, and but for his amiable disposition and 
the persistent eflfbrts of his mother, who never left 
him, he certainly would have died from lack of nour- 
ishment. On the 20th he sat up. The next day he 
walked across the room, and the day following went 
into the adjoining room. On the 23d I was summoned 
in great haste, the mother being very much alarmed 
because he could not walk. In a few days, however, 
he was on his feet again, but his gait was as uncertain 
as if quite thoroughly under the influence of brandy. 
I frequently saw him unable to come within four feet 
of a door that he attempted to pass, and without sup- 



port, in the middle ot the floor, he was an object of 
amusement to himself, because, as he said, his " legs 
wouldn't work." He gradually grew stronger, but as 
his strength returned and he was enabled to walk more 
surely, his sight became 'impaired, so that he could 
not tell his brothers across the dinner table, when 
I saw hii^ New Year day. This condition .continued 
about a week, but as if to compensate him for his 
week's loss of sight, he now saw everything double, 
except it was within two or three inches of his nose ; 
but as his strength increased the distance of double 
vision increased, till it entirely disappeared. I made 
my last visit to him January 28th. 

I note this one, because out of a considerable num- 
ber of cases 'seen during the past year, I have never 
seen as severe a case recover, or one of so long dura- 
tion ; neither have I seen the af ter-eflects of the disease 
so well marked. The treatment consisted in the first 
part of quinia, tr. iron, internally and locally. The 
gargle before mentioned was used throughout. Sali- 
cylic acid was used locally, I think without benefit. 
The diet consisted of milk, milk punch, beef tea, port 
wine, broths, ice cream, grapes and such other fruit 
as he desired. I take it from this case that if ''beef 
tea is useless and not at all nutritious," it is, at leas* 
not a very active poison, otherwise this child won 
have died a victim to it, for he took each day, for i ' 
first twenty days of his sickness, the tea from ' 
pounds of choice beef. 

On the 5th of May, a singular accident occuried • 
the depot in this city. As the morning 
passed through, Mr. Thomas Page, " the pa 
aged 62, was standing on the platform wit 
toward the passing train. The mail bag waa 


from the car striking the old man on the left breast, 
knocking him down, and, as it were, forcing his body 
forward, while the right hip coming in contact with the 
platform, produced an injury which made it impossi- 
ble for him to stand when assisted to his feet. I saw 
him in a few minutes after the accident, and feared a 
fracture of the neck of the femur. Later in the day, 
with the assistance of Dr. D. W. C. Hough, the pa- 
tient was thoroughly aetherized and my worst fears 
were rea:lized. It was a fracture of the neck of the 
femur within the capsular ligament. 

My excuse for taking up so much of this report with 
my own cases is, that out of seven sub reporters, from 
all of whom reports liave been solicited, only two have 
responded ; one in four lines of note paper, says there 
has been no sickness in his vicinity, and Dr. Schleimer's 
report of a case is enclosed. 

H. H. JAMES, BepoTter, 
RAirwAY, N. J., May 12, 1876. 

Communication by David Schleimer, M. D. 

The year has been with ns a remarkably healthy one, so much so as 
to offer no material for an elaborate report. Of the cases wortliy of 
notice, that have come under my obseryation, are about 20 cases of 
diphtheria, some of which were of a severe character; all however 
have recovered, though some remarkably slow and tedious. One 
case in particular I will mention, who has been treated almost 
inexcusably heroic, to which I was led by two reasons : 

1st. The very desperate character of the case; and 2d, The 
similarity, in my opinion, of this disease with membranous croup. 

The patient in question is John Green, a native of England, aged 
about 35 years, mariied, and by occupation a laborer. I was called to 
his hous3 on February 1st, to see one of his children who had a mild 
attack of diphtheria, the father then being in apparent good health. 
The child did well, and recovered in a week or so, when the father 


was taken ^ith r ybtj severe headache, fever, general anoreiia, eoroe 
coQgb, without any further poaitire Bjmptam, Uj diagnosis was 
accordingly gnarded. 

Attended the patient for two 'or three days, when upon another ez- 
aminatiea of his throat, to which I waa led by hia inability to swallow 
anytbicg, even a drink of water, without considerable pain, I now 
found a diphtheritic exudation covering both tonsils and uvula, and 
at once resorted to usual remedies for that diseaae. 

The next morning I found him declining fast, unable to utter a 
word above a whisper, and that was attended by pain. The exudation 
had extended to the roof of the month, his toD);ue covered with a 
thick brown coating, so dry as to almost form a crust;' pnlae 140. 
Death seemed written in his anxious countenance. I made up my 
mind it was nseleea to continue with the uaual remedies ; in fact, he 
was, to my mind, beyond any remedy that might be resorted to. I re- 
solved, for the reasons above mentioned, on the following treatment : 

B Hydr. Chlor. Mi 
Sacch. Alb. 
M. ft. chart N( 

8. one every three hours, and le 
strictly comply with the direction; 
the almost impossibility of his rei 

Called the neit morning; th 
thought, a perceptible change in ( 
the face did not present quite 
thought him somewhat more hop 
his mouth. I repeated the i 

The next morning I found twi 
at intervals, and to my great sur]; 
mouth ; the exudation began di 
the further uee of this remedy a 
doses; some quinia with iron, a 
this time he continued to improv 
day, until the mouth was thorouf 
and oa the 25tb of February ho 
smoke. The man is now as well : 

I cite this case because I consiL 


war on this time-honored remedy. While young in the profession, I 
have seen enough of the value of this much abused article to consider 
it the remedy in many cases, not however in such doses as mentioned 
Elizabrthpobt, May, 1876. 


To Chairman of Standing Committee^ &c. : 

The past year has been a very busy one for the prac- 
titioners of this County. The prominent diseases 
treated were Dysentery, Typhoid Fever, Diphtheria, 
Measles and Pneumonia. I hear of Scarlet Fever only 
in the isolated township of Pahaquarry. There it was 
mild and unattended with fatality. 

In remarking upon the salient points presented in 
the history of these epidemics, I mention — 

First, that the Dysentery of the summer and fall 
months was not of a very fatal character. But two or 
three deaths occurred, and these from the incoming of 
cerebro-spinal symptoms to complicate the intestinal 
affection. In addition to the standard corrective and 
opiate,treatment, which has stood the test of experience, 
the use of small doses of belladonna was very efficient 
in allaying the tenesmus as well as the nervous symp- 
toms. With this the bi-sulphite of soda as corrective 
and disinfectant, and the bromides pro re nata^ and 
we had a system of treatment quite gratifying in its 
its results. 

Diphtheria was very prevalent at Oxford and in the 
borough of Washington. The absence of reports from 
the resident practitioners, as to its character and treat- 
ment, is to be regretted. 

The epidemic of Measles has been wide-spread. 


commencing in October last. We are still attending . 
cases of this dis^^ase. Its individliaL type is mild, and 
when without complication has been entirely free from 

In quite a number of cases, Pneumonia was inter- 
current. This was treated very much in the same 
method as that occurring so frequently during the 
winter in persons unaffected by the exanthema. The 
treatment consisted in moderating febrile symptoms 
cautiously with tart, anti., verat. virid. or ipecac, and 
then relying upon quinine with either ammonia or 
whiskey : blisters and fomentations externally. 

In answer to questions from the Chairman of , Stand- 
ing Committee — Dr. Ci-ane remarks that " the value of 
topical remedies in 
upon their antiseptic 
all cauterizing reme 
concerning " calome 
Doctor replies that 
in serous inflamma 

The reporter addi 
catliartic or frequent 
ished since the intrr 
by which we avoid tl 
able effects of the i 
hydg. creta or blue 
lowed by chlor. pot. 

Notably, however, 
viz : in croup or lar 
gastric spasm, and ii 

As these diverse i 
common, viz : an iniii 


• with abundant tenacious secretions of mncns, the 
solvent action of calomel on these morbid albuminons 
products has a marked effect in relieving the capillary 
congestion of the subjacent tisanes, and relieving the 
the spasmodic effort, which is so variously manifested 
in each of these several diseases. 

J. C. JOHNSON, Seporter. 
Blaibgtown, Uaj 18, 1876. 

The Medical Society of New Jergey does not hold itself respondble 
for the KntJmentB expressed b; the anthon of papers ; nor for the 
accnracy of the reports of clinical caseB famished by the reporters of 
the District Societies. 


OFF1CERS-18IB... ""'o 


HONORARY MEMBERS... ,'.".'. 5 



APPENDIS TO minutes!! 80 

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EsaAT bj John S. Cook, M. D. BS 


E-BAT by E. P. Townsend, U. D 9S 




Cbaklkj 8. Champion 128 

Addhoh W, Woodhdu, 1 128 

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Charlks Miltom Lbb lai 

NateoN D.W.T.Stbtkeb..... '.'.'.' 183 

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Jajibb Vamdejipool '" 143 

Elijah W. Maikb.. lio 



Cabeb by Dr. a. Clondama— 

CoMMDMicATiOHB by D. A, Cume, M. "d!- 



('oUHrmrjiTiiiii by Dr. Brown.. 

l.jDr. I'rica .. 


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